Published in:
Open Access 01-12-2013 | Research article
Endoscopic gallbladder stenting for acute cholecystitis: a retrospective study of46 elderly patients aged 65 years or older
Published in: BMC Gastroenterology | Issue 1/2013
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Background
Endoscopic transpapillary pernasal gallbladder drainage and endoscopicgallbladder stenting (EGS) have recently been reported to be useful inpatients with acute cholecystitis for whom a percutaneous approach iscontraindicated. The aim of this study was to evaluate the efficacy ofpermanent EGS for management of acute cholecystitis in elderly patients whowere poor surgical candidates.
Methods
We retrospectively studied 46 elderly patients aged 65 years or older withacute cholecystitis who were treated at Japan Labour Health and WelfareOrganization Niigata Rosai Hospital. In 40 patients, acute cholecystitis wasdiagnosed by transabdominal ultrasonography and computed tomography, while 6patients were transferred from other hospitals after primary management ofacute cholecystitis. All patients underwent EGS, with a 7Fr double pig-tailstent being inserted into the gallbladder. If EGS failed, percutaneoustranshepatic gallbladder drainage or percutaneous transhepatic gallbladderaspiration was subsequently performed. The main outcome measure of thisstudy was the efficacy of EGS.
Results
Permanent EGS was successful in 31 patients (77.5%) with acute cholecystitis,without any immediate postprocedural complications such as pancreatitis,bleeding, perforation, or cholangitis. The most common comorbidities ofthese patients were cerebral infarction (n=14) and dementia (n=13). In 30 ofthese 31 patients (96.7%), there was no recurrence of cholecystitis and 29patients (93.5%) remained asymptomatic until death or the end of the studyperiod (after 1 month to 5 years).
Conclusions
EGS can be effective for elderly patients with acute cholecystitis who arepoor surgical candidates and can provide a solution for several years.