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. 2024 Feb 13;14(4):413.
doi: 10.3390/diagnostics14040413.

EUS-Guided Gallbladder Drainage Using a Lumen-Apposing Metal Stent for Acute Cholecystitis: Results of a Nationwide Study with Long-Term Follow-Up

Cecilia Binda  1 , Andrea Anderloni  2 , Edoardo Forti  3 , Pietro Fusaroli  4 , Raffaele Macchiarelli  5 , Mauro Manno  6 , Alessandro Fugazza  7 , Alessandro Redaelli  8 , Giovanni Aragona  9 , Mauro Lovera  10 , Thomas Togliani  11 , Elia Armellini  12 , Arnaldo Amato  13 , Mario Luciano Brancaccio  14 , Roberta Badas  15 , Nicola Leone  16 , Germana de Nucci  17 , Benedetto Mangiavillano  18 , Monica Sbrancia  1 , Valeria Pollino  19 , Andrea Lisotti  4 , Marcello Maida  20   21 , Emanuele Sinagra  22 , Marco Ventimiglia  23 , Alessandro Repici  7   24 , Carlo Fabbri  1 , Ilaria Tarantino  25
Affiliations

EUS-Guided Gallbladder Drainage Using a Lumen-Apposing Metal Stent for Acute Cholecystitis: Results of a Nationwide Study with Long-Term Follow-Up

Cecilia Binda et al. Diagnostics (Basel). .

Abstract

Background: Although endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) using lumen-apposing metal stents (LAMS) has become one of the treatments of choice for acute cholecystitis (AC) in fragile patients, scant data are available on real-life settings and long-term outcomes.

Methods: We performed a multicenter retrospective study including EUS-guided GBD using LAMS for AC in 19 Italian centers from June 2014 to July 2020. The primary outcomes were technical and clinical success, and the secondary outcomes were the rate of adverse events (AE) and long-term follow-up.

Results: In total, 116 patients (48.3% female) were included, with a mean age of 82.7 ± 11 years. LAMS were placed, transgastric in 44.8% of cases, transduodenal in 53.3% and transjejunal in 1.7%, in patients with altered anatomy. Technical success was achieved in 94% and clinical success in 87.1% of cases. The mean follow-up was 309 days. AEs occurred in 12/116 pts (10.3%); 8/12 were intraprocedural, while 1 was classified as early (<15 days) and 3 as delayed (>15 days). According to the ASGE lexicon, two (16.7%) were mild, three (25%) were moderate, and seven (58.3%) were severe. No fatal AEs occurred. In subgroup analysis of 40 patients with a follow-up longer than one year, no recurrence of AC was observed.

Conclusions: EUS-GBD had high technical and clinical success rates, despite the non-negligible rate of AEs, thus representing an effective treatment option for fragile patients.

Keywords: EUS-guided drainage; EUS-guided gallbladder drainage; acute cholecystitis; lumen apposing metal stent.

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Conflict of interest statement

C.B.: Lecturer for Steris, Fujifilm, Boston Scientific, Q3 Medical. A.A.: Consultant for Boston Scientific. P.F.: Consultant for Boston Scientific, Lecturer for Olympus. A.F.: Consultant for Boston Scientific. M.M.: is on an advisory board and is lecturer for Norgine. A.R.: has received research grants and speaker’s fees from Boston Scientific, Fujifilm and Norgine; he is also on an advisory board for Fujifilm. E.F., R.M., M.M., A.R., G.A., M.L., T.T., E.A., A.A., M.L.B., R.B., N.L., G.d.N., B.M., M.S., V.P., A.L., E.S. and I.T.: no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Severity grading of AC according to Tokyo guidelines.
Figure 2
Figure 2
Procedural steps of EUS-GBD using LAMS.
See this image and copyright information in PMC

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