Aug 21, 2009

Endosonography-guided gallbladder drainage for acute cholecystitis following covered metal stent deployment

Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society
Osamu TakasawaTakashi Obana

Abstract

Endosonography-guided biliary drainage (ESBD) is gaining acceptance as an effective treatment for obstructive jaundice. Only a few reports on the application of this technique to the gallbladder (endosonography-guided gallbladder drainage [ESGBD]) have been published in the literature. In order to relieve acute cholecystitis which developed in a patient with unresectable malignant biliary obstruction after deployment of a covered metal stent (CMS), we applied this technique. ESGBD was carried out by using an electronic curved linear array echoendoscope. After visualization of the gallbladder and determination of the puncture route, a needle knife papillotome was advanced with electrocautery to pierce the gastric and gallbladder walls. Under the guidance of a guidewire inserted through the needle sheath into the gallbladder, a 7.2 Fr, 30 cm-long, single pigtail plastic tube was placed to bridge the gallbladder and the stomach. No complications relevant to the procedure were encountered. ESGBD was quite effective in ameliorating the patient's acute cholecystitis and the drainage tube was removed after 10 days without sequelae. Acute cholecystitis following CMS deployment is considered to be a good indication for ESGBD.

  • References23
  • Citations11

Citations

Mentioned in this Paper

Jaundice, Obstructive
Stent, Device
Malignant Neoplasm of Pancreas
Gallbladder (Mmhcc)
Puncture Procedure
Bile Duct Carcinoma
Endoscopic Ultrasound
Malignant Paraganglionic Neoplasm
Foreskin of Penis
Anaplastic Oligodendroglioma

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