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. 2021 Sep 2;2(1):e40.
doi: 10.1002/deo2.40. eCollection 2022 Apr.

Permanent endoscopic transpapillary gallbladder drainage using a novel spiral stent (IYO-stent)

Yuichi Takano  1 , Jun Noda  1 , Masataka Yamawaki  1 , Tetsushi Azami  1 , Takahiro Kobayashi  1 , Fumitaka Niiya  1 , Naotaka Maruoka  1 , Tatsuya Yamagami  1 , Masatsugu Nagahama  1
Affiliations

Permanent endoscopic transpapillary gallbladder drainage using a novel spiral stent (IYO-stent)

Yuichi Takano et al. DEN Open. .

Abstract

Background and aim: Endoscopic transpapillary gallbladder drainage (ETGBD) is widely performed. However, there is no consensus on the appropriate diameter, length, and shape of the stent that should be used in this procedure. In addition, there are limited data on the outcomes of permanent ETGBD. In our facility, a stent with a novel spiral structure (IYO-stent) is permanently placed in patients with acute cholecystitis who are not indicated for surgery. This study examined the efficacy and safety of the IYO-stent in cases of permanent ETGBD.

Methods: We retrospectively examined patients who underwent permanent ETGBD using the IYO-stent from April 2018 to December 2020.

Results: Eleven patients were included in this study. The technical success and the clinical success rate were 91%. One patient had a post-procedure adverse event (post-endoscopic sphincterotomy bleeding). Within the median observation period of 312 days (range: 109-742), late adverse events, including cholangitis (n = 1) and incomplete stent migration (n = 1), were observed. However, none of the patients experienced cholecystitis relapse.

Conclusion: Permanent ETGBD with IYO-stent is an effective treatment for the patients with acute cholecystitis who are not indicated for surgery.

Keywords: acute cholecystitis; endoscopic transpapillary gallbladder drainage.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

FIGURE 1
FIGURE 1
A 5‐Fr transpapillary gallbladder stent (IYO‐stent). The stent has only one size (diameter: 5 Fr, length: 32 cm) and has a novel spiral structure. The spiral part has a circular diameter of 3 cm and has 36 side holes. There are six side holes on the duodenal side
FIGURE 2
FIGURE 2
Endoscopic transpapillary gallbladder drainage using the IYO‐stent. Note the unique spiral shape in the gallbladder
FIGURE 3
FIGURE 3
Immediately after placement, the lower end of the IYO‐stent was found in the second portion of the duodenum. Percutaneous transhepatic gallbladder drainage is already indwelled
FIGURE 4
FIGURE 4
(a) A same case as observed in Figure 3. Plain radiography of the abdomen 3 months after the procedure. The distal end of the stent migrated to the third portion of the duodenum. (b) Computed tomography images revealed that the tip of the stent remained in the gallbladder. There was no cholecystitis relapse. We recommended stent replacement. However, the patient refused. Hence, follow‐up examination was performed
See this image and copyright information in PMC

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