| Article ID | Journal | Published Year | Pages | File Type |
|---|---|---|---|---|
| 3307354 | Gastrointestinal Endoscopy | 2010 | 7 Pages |
BackgroundAlthough the definitive therapy of acute cholecystitis is cholecystectomy, nonsurgical treatment such as percutaneous cholecystostomy could be indicated in patients who are unsuitable candidates for cholecystectomy. EUS-guided cholecystoenterostomy with a plastic stent and/or nasobiliary drainage has been proposed as an alternative effective treatment for these patients.ObjectiveWe conducted this study to evaluate the technical feasibility, safety, usefulness, and follow-up results of EUS-guided cholecystoenterostomy with single-step placement of a plastic stent for patients with acute cholecystitis who are unsuitable candidates for cholecystectomy.DesignA prospective feasibility study with a case series.SettingTertiary teaching hospital.PatientsEight consecutive patients diagnosed with acute cholecystitis who were poor candidates for surgery.InterventionsEUS-guided cholecystoenterostomy with single-step placement of a 7F double-pigtail plastic stent.Main Outcome MeasurementsTechnical success, clinical resolution of acute cholecystitis, procedure-related complications, and recurrence of cholecystitis.ResultsTechnical success and clinical resolution were achieved in all patients (100% [8/8] as intent to treat). A transduodenal approach was used for 7 patients and a transgastric approach for 1 patient. One patient showed self-limited pneumoperitoneum, and bile peritonitis occurred in 1 patient. One patient showed distal stent migration without bile leakage 3 weeks after stent insertion. During follow-up periods (median 186 days; range 22-300 days), cholecystitis did not recur in any patients.LimitationsSmall number of patients.ConclusionEUS-guided cholecystoenterostomy with single-step placement of a 7F double-pigtail plastic stent may be a feasible and useful alternative in patients with acute cholecystitis who are unsuitable candidates for cholecystectomy.
