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. 2025 Jan 13:13:a24955542.
doi: 10.1055/a-2495-5542. eCollection 2025.

US multicenter outcomes of endoscopic ultrasound-guided gallbladder drainage with lumen-apposing metal stents for acute cholecystitis

Yakira David  1 , Gaurav Kakked  2 , Bradley Confer  3 , Ruchit Shah  4 , Harshit Khara  4 , David L Diehl  3 , Matthew Richard Krafft  5 , Sardar M Shah-Khan  6 , John Y Nasr  7 , Petros Benias  8 , Arvind Trindade  9 , Thiruvengadam Muniraj  10 , Harry Aslanian  11 , Prabhleen Chahal  12 , John Rodriguez  12 , Douglas G Adler  13 , Jason Dubroff  14 , Rabi De Latour  15 , Demetrios Tzimas  16 , Lauren Khanna  15 , Gregory Haber  15 , Adam J Goodman  17 , Nicholas Hoerter  18 , Nishi Pandey  19 , Mena Bakhit  20 , Thomas E Kowalski  21 , David Loren  22 , Austin Chiang  23 , Alexander Schlachterman  24 , Jose Nieto  25 , Ameya Deshmukh  26 , Yervant Ichkhanian  27 , Mouen A Khashab  28 , Maan El Halabi  29 , Richard S Kwon  30 , Anoop Prabhu  31 , Ariosto Hernandez-Lara  32 , Andrew Storm  32 , Tyler M Berzin  33 , John Poneros  34 , Amrita Sethi  35 , Tamas A Gonda  36 , Vladimir Kushnir  37 , Natalie Cosgrove  38 , Daniel Mullady  37 , Abdullah Al-Shahrani  39 , Lionel D'Souza  40 , Jonathan Buscaglia  41 , Juan Carlos Bucobo  42 , Vineet Rolston  43 , Prashant Kedia  44 , Franklin Kasmin  45 , Satish Nagula  46 , Nikhil A Kumta  47 , Christopher DiMaio  48
Affiliations

US multicenter outcomes of endoscopic ultrasound-guided gallbladder drainage with lumen-apposing metal stents for acute cholecystitis

Yakira David et al. Endosc Int Open. .

Abstract

Background and study aims: EUS-guided gallbladder drainage (EUS-GBD) using lumen apposing metal stents (LAMS) has excellent technical and short-term clinical success for acute cholecystitis (AC). The goals of this study were to determine the long-term clinical outcomes and adverse events (AEs) of EUS-GBD with LAMS.

Patients and methods: A multicenter, retrospective study was conducted at 18 US tertiary care institutions. Inclusion criteria: any AC patient with attempted EUS-GBD with LAMS and minimum 30-day post-procedure follow-up. Long-term clinical success was defined as absence of recurrent acute cholecystitis (RAC) > 30 days and long-term AE was defined as occurring > 30 days from the index procedure.

Results: A total of 109 patients were included. Technical success was achieved in 108 of 109 (99.1%) and initial clinical success in 106 of 109 (97.2%). Long-term clinical success was achieved in 98 of 109 (89.9%) over a median follow-up of 140 days (range 30-1188). On multivariable analysis (MVA), acalculous cholecystitis (odds ratio [OR] 15.93, 95% confidence interval [CI] 1.22-208.52, P = 0.04) and the occurrence of a LAMS-specific AE (OR 63.60, 95% CI 5.08-799.29, P <0.01) were associated with RAC. AEs occurred in 38 of 109 patients (34.9%) at any time, and in 10 of 109 (9.17%) > 30 days from the index procedure. Most long-term AEs (7 of 109; 6.42%) were LAMS-specific. No technical or clinical factors were associated with occurrence of AEs. LAMS were removed in 24 of 109 patients (22%). There was no difference in RAC or AEs whether LAMS was removed or not.

Conclusions: EUS-GBD with LAMS has a high rate of long-term clinical success and modest AE rates in patients with AC and is a reasonable destination therapy for high-risk surgical candidates.

Keywords: Biliary tract; Endoscopic ultrasonography; Intervention EUS; Performance and complications; Quality and logistical aspects.

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Conflict of interest statement

Conflict of Interest Conflicts of Interest and Sources of Funding: There was no financial support for this study. Harry Aslanian: Olympus (consultant), Boston Scientific (consultant). Prabhleen Chahal: Advisory council Medtronic, Boston Scientific (consultant). Rabia DeLatour: Ambu (consultant). David L. Diehl: Boston Scientific (consultant). Christopher J. DiMaio: Boston Scientific (consultant, speaker), Medtronic (consultant, speaker). Tamas A. Gonda: Boston Scientific (Research support). Thomas Kowalski: Boston Scientific (consultant), Medtronic (consultant). Nikhil A. Kumta: Boston Scientific (consultant, speaker), Olympus (consultant), Apollo Endosurgery (consultant, speaker). Dan Mullady: Boston Scientific (consultant), Cook (consultant). John Y. Nasr: Boston Scientific (consultant). Jose Nieto: Boston Scientific (consultant). Alexander Schlachterman: Lumendi (consultant), ConMed (consultant), Olympus (consultant), Medtronic (consultant), FujiFilm (consultant). Andrew Storm: Apollo Endosurgery (consultant and research grants), ERBE (consultant), Boston Scientific (research grants). All other authors: No conflicts of interest

Figures

Fig. 1
Fig. 1
Lumen-apposing metal stent.
Fig. 2
Fig. 2
Choledochoduodenostomy with lumen-apposing metal stent.
See this image and copyright information in PMC

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