Nakabayashi Ryota, Kamada Hideki, Ono Masahiro, Kono Toshiaki, Fujita Naoki, Yamana Hiroki, Kobayashi Kiyoyuki, Tani Joji, Ando Yasuhisa, Suto Hironobu, Oshima Minoru, Okano Keiichi, Kobara Hideki
Department of Gastroenterology and Neurology Institute of Medicine Kagawa University Kagawa Japan.
Division of Innovative Medicine for Hepatobiliary and Pancreatology Institute of Medicine Kagawa University Kagawa Japan.
DEN Open. 2024 Dec 26;5(1):e70047. doi: 10.1002/deo2.70047. eCollection 2025 Apr.
Limitations are sometimes encountered in the application of laparoscopic cholecystectomy to the treatment of acute cholecystitis. Endoscopic gallbladder stenting (EGBS) has emerged as an additional option. However, the long-term stent patency remains an issue. This study was performed to compare the efficacy of primary and secondary EGBS.
Sixty-one patients who underwent preplanned EGBS because of poor surgical tolerance from January 2006 to July 2023 were retrospectively analyzed. The patients were divided into the initial EGBS group, in which EGBS was performed as the first option ( = 37), and the secondary EGBS group, in which EGBS was performed following other treatments ( = 24). The primary endpoint was the 3-month recurrence rate, and the secondary endpoint was the technical success rate. Propensity score matching was performed to align the patients' background factors between the two groups.
After propensity score matching, six patients from each group were selected for analysis. The technical success rate was significantly higher in the secondary EGBS group (73.0% [27/37] vs. 95.8% [23/24], respectively). Furthermore, the 3-month recurrence rate was significantly higher in the initial than secondary EGBS group (66.7% [4/6] vs. 0.0% [0/6], respectively; = 0.0232).
Secondary EGBS may effectively prevent recurrent cholecystitis in patients with poor surgical tolerance.
腹腔镜胆囊切除术应用于急性胆囊炎的治疗时，有时会遇到局限性。内镜下胆囊支架置入术（EGBS）已成为一种额外的选择。然而，支架的长期通畅性仍然是一个问题。本研究旨在比较原发性和继发性EGBS的疗效。
回顾性分析2006年1月至2023年7月因手术耐受性差而接受预先计划的EGBS的61例患者。患者分为初始EGBS组（n = 37），即EGBS作为首选治疗方法；以及继发性EGBS组（n = 24），即EGBS在其他治疗之后进行。主要终点是3个月复发率，次要终点是技术成功率。进行倾向评分匹配以平衡两组患者的背景因素。
倾向评分匹配后，每组各选择6例患者进行分析。继发性EGBS组的技术成功率显著更高（分别为73.0% [27/37]和95.8% [23/24]）。此外，初始EGBS组的3个月复发率显著高于继发性EGBS组（分别为66.7% [4/6]和0.0% [0/6]；P = 0.0232）。
继发性EGBS可能有效预防手术耐受性差的患者复发性胆囊炎。
