Transpapillary gallbladder stent placement for long-term therapy of acute cholecystitis

Storm, Andrew C.; Vargas, Eric J.; Chin, Jerry Yung-Lun; Chandrasekhara, Vinay; Dayyeh, Barham K. Abu; Levy, Michael J.; Martin, John A.; Topazian, Mark D.; Andrews, James C.; Schiller, Henry J.; Kamath, Patrick S.; Petersen, Bret T.

doi:10.1016/j.gie.2021.03.025

Cited by 30 publications

(33 citation statements)

References 19 publications

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“… Forest plot showing the individual study proportions of endoscopic transpapillary gallbladder drainage related adverse events in relation to the pooled rate[ 7 , 9 , 22 , 24 - 39 ] . …”

Section: Resultsmentioning

confidence: 99%

Efficacy and safety of endoscopic transpapillary gallbladder drainage in acute cholecystitis: An updated meta-analysis

Jandura¹,

Puli²

2021

WJGE

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BACKGROUND Percutaneous transhepatic gallbladder drainage has been the most frequently performed treatment for acute cholecystitis for patients who are not candidates for surgery. Endoscopic transpapillary gallbladder drainage (ETGBD) has evolved into an alternative treatment. There have been numerous retrospective and prospective studies evaluating ETGBD for acute cholecystitis, though results have been variable. AIM To evaluate the efficacy and safety of ETGBD in the treatment of inoperable patients with acute cholecystitis. METHODS We performed a systematic review of major literature databases including PubMed, OVID, Science Direct, Google Scholar (from inception to March 2021) to identify studies reporting technical and clinical success, and post procedure adverse events in ETGBD. Weighted pooled rates were then calculated using fixed effects models for technical and clinical success, and post procedure adverse events, including recurrent cholecystitis. RESULTS We found 21 relevant articles that were then included in the study. In all 1307 patients were identified. The pooled technical success rate was 82.62% [95% confidence interval (CI): 80.63-84.52]. The pooled clinical success rate was found to be 94.87% (95%CI: 93.54-96.05). The pooled overall complication rate was 8.83% (95%CI: 7.42-10.34). Pooled rates of post procedure adverse events were bleeding 1.03% (95%CI: 0.58-1.62), perforation 0.78% (95%CI: 0.39-1.29), peritonitis/bile leak 0.45% (95%CI: 0.17-0.87), and pancreatitis 1.98% (95%CI: 1.33-2.76). The pooled rates of stent occlusion and migration were 0.39% (95%CI: 0.13-0.78) and 1.3% (95%CI: 0.75-1.99) respectively. The pooled rate of cholecystitis recurrence following ETGBD was 1.48% (95%CI: 0.92-2.16). CONCLUSION Our meta-analysis suggests that ETGBD is a feasible and efficacious treatment for inoperable patients with acute cholecystitis.

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“… Forest plot showing the individual study proportions of endoscopic transpapillary gallbladder drainage related adverse events in relation to the pooled rate[ 7 , 9 , 22 , 24 - 39 ] . …”

Section: Resultsmentioning

confidence: 99%

Efficacy and safety of endoscopic transpapillary gallbladder drainage in acute cholecystitis: An updated meta-analysis

Jandura¹,

Puli²

2021

WJGE

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“…However, a recent study with a mean follow-up of 453 days did find a greater risk of recurrent cholecystitis in those individuals where the stent was removed. 27 Larger studies with longer follow-up are required to determine how long stents should be left in place in asymptomatic patients. Currently, there are no guidelines to recommend either stent removal or stent exchange.…”

Section: Endoscopic Transpapillary Gbdmentioning

confidence: 99%

Endoscopic therapies for gallbladder drainage

Saumoy

Yang

Bhatt

et al. 2021

Gastrointestinal Endoscopy

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“…ENGBD and EGBS are classified as transpapillary approaches; a naso-gallbladder tube is placed in ENGBD and a plastic stent extending from the gallbladder to the duodenum is placed in EGBS [ 9 ]. Since EGBS is an internal fistula method, the tube can be indwelling for a long period of time without impairing a patient’s quality of life; in fact, long-term placement can be useful in preventing cholecystitis recurrence in patients with end-stage liver disease [ 10 , 11 , 12 ] and poor surgical candidates [ 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ] ( Figure 1 ). Based on research surrounding biliary stent placement for malignant or benign biliary strictures, it is unlikely that the stent will remain patent for years [ 27 , 28 ].…”

Section: Egbs Vs Ptgbd For Long-term Outcomesmentioning

confidence: 99%

Long-Term Outcomes of Endoscopic Gallbladder Drainage for Cholecystitis in Poor Surgical Candidates: An Updated Comprehensive Review

Inoue

Yoshida

Suzuki

et al. 2021

JCM

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Laparoscopic cholecystectomy is the standard and fundamental treatment of choice for acute cholecystitis; however, there are cases in which patients may be poor surgical candidates due to advanced age, comorbidities, and/or general condition. The rate of recurrent cholecystitis is high in patients who are not surgically treated; therefore, the prevention of recurrence in this patient population is an important subject of investigation in the management of cholecystitis. Although it has recently been reported that long-term stent placement by endoscopic gallbladder stenting or endoscopic ultrasound-guided gallbladder drainage may reduce the recurrence rate, its efficacy and safety remain controversial. Additionally, details surrounding the long-term stent management of these treatment methods should be further investigated. In this review, we summarize the updated evidence regarding the usefulness of long-term stent placement with endoscopic gallbladder stenting or endoscopic ultrasound-guided gallbladder drainage as a preventive measure for recurrence of cholecystitis and discuss issues that should be addressed in future studies.

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Transpapillary gallbladder stent placement for long-term therapy of acute cholecystitis

Cited by 30 publications

References 19 publications

Efficacy and safety of endoscopic transpapillary gallbladder drainage in acute cholecystitis: An updated meta-analysis

Efficacy and safety of endoscopic transpapillary gallbladder drainage in acute cholecystitis: An updated meta-analysis

Endoscopic therapies for gallbladder drainage

Long-Term Outcomes of Endoscopic Gallbladder Drainage for Cholecystitis in Poor Surgical Candidates: An Updated Comprehensive Review

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