Suzuki Eisuke, Fujita Yuji, Hosono Kunihiro, Koyama Yuji, Tsujino Seitaro, Teratani Takuma, Nakajima Atsushi, Matsuhashi Nobuyuki
Department of Hepato-Biliary-Pancreatic Medicine, NTT Tokyo Medical Center, Tokyo, Japan.
Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan.
Clin Endosc. 2023 Sep;56(5):650-657. doi: 10.5946/ce.2022.190. Epub 2023 Apr 5.
BACKGROUND/AIMS: Endoscopic ultrasound gallbladder drainage (EUS-GBD) is gaining attention as a treatment method for cholecystitis. However, only a few studies have assessed the outcomes of permanent stenting with EUS-GBD. Therefore, we evaluated the clinical outcomes of permanent stenting using EUS-GBD.
This was a retrospective, single-center cohort study. The criteria for EUS-GBD at our institution are a high risk for surgery, inability to perform surgery owing to poor performance status, and inability to obtain consent for emergency surgery. EUS-GBD was performed using a 7-Fr double-pigtail plastic stent with a dilating device. The primary outcomes were the recurrence-free rate of cholecystitis and the late-stage complication-avoidance rate. Secondary outcomes were technical success, clinical success, and procedural adverse events.
A total of 41 patients were included in the analysis. The median follow-up period was 168 (range, 10-1,238) days. The recurrence-free and late-stage complication-avoidance rates during the follow-up period were 95% (38 cases) and 90% (36 cases), respectively. There were only two cases of cholecystitis recurrence during the study period.
EUS-GBD using double-pigtail plastic stent was safe and effective with few complications, even in the long term, in patients with acute cholecystitis.
背景/目的：内镜超声引导下胆囊引流术（EUS-GBD）作为胆囊炎的一种治疗方法正受到关注。然而，仅有少数研究评估了EUS-GBD置入永久性支架的疗效。因此，我们评估了使用EUS-GBD置入永久性支架的临床疗效。
这是一项回顾性单中心队列研究。我们机构进行EUS-GBD的标准为手术高风险、因身体状况差无法进行手术以及无法获得急诊手术同意。使用带扩张装置的7Fr双猪尾塑料支架进行EUS-GBD。主要结局为胆囊炎无复发率和晚期并发症避免率。次要结局为技术成功率、临床成功率和手术不良事件。
共有41例患者纳入分析。中位随访期为168（范围10 - 1238）天。随访期间无复发率和晚期并发症避免率分别为95%（38例）和90%（36例）。研究期间仅2例胆囊炎复发。
对于急性胆囊炎患者，使用双猪尾塑料支架的EUS-GBD即使在长期也是安全有效的，并发症较少。
