Jason D Conway1, Mark W Russo, Roshan Shrestha. 1. Department of Medicine: Division of Gastroenterology and Hepatology, Center for Gastrointestinal Biology and Disease, University of North Carolina, Chapel Hill, 27599-7080, USA.
Abstract
BACKGROUND: Endoscopic stent insertion into the gallbladder entails placement of a double-pigtail polyethylene stent between the gallbladder and the duodenum at ERCP. This procedure may be an effective temporary measure in patients with severe comorbid conditions, especially end-stage liver disease, that subsequently allows more definitive therapy, including liver transplantation. METHODS: The records for 29 patients who underwent attempted endoscopic gallbladder stent insertion between May 1999 and May 2004 were reviewed retrospectively. RESULTS: Mean patient age was 47 years; 86% of the patients were listed for liver transplantation, with a mean model for end-stage liver disease score of 15; 72% had Child's class B cirrhosis. Indications for gallbladder stent placement included recurrent biliary colic (69%), acute cholecystitis (17%), acalculous cholecystitis (7%), and gallstone pancreatitis (7%). Of the 29 patients who underwent ERCP, stent placement was successful in 26 (90%). Median follow-up was 9.4 months (range 0.1-40.5 months). Of those who had a stent placed, 6 (22%) subsequently underwent liver transplantation and another 15 (56%) were alive, most awaiting liver transplantation. Only 3 patients had late a complication or recurrence of biliary symptoms after stent placement. CONCLUSIONS: Endoscopic stent placement in the gallbladder is a safe and an effective palliative treatment for patients with symptoms caused by gallbladder disease who are poor surgical candidates.
BACKGROUND: Endoscopic stent insertion into the gallbladder entails placement of a double-pigtail polyethylene stent between the gallbladder and the duodenum at ERCP. This procedure may be an effective temporary measure in patients with severe comorbid conditions, especially end-stage liver disease, that subsequently allows more definitive therapy, including liver transplantation. METHODS: The records for 29 patients who underwent attempted endoscopic gallbladder stent insertion between May 1999 and May 2004 were reviewed retrospectively. RESULTS: Mean patient age was 47 years; 86% of the patients were listed for liver transplantation, with a mean model for end-stage liver disease score of 15; 72% had Child's class B cirrhosis. Indications for gallbladder stent placement included recurrent biliary colic (69%), acute cholecystitis (17%), acalculous cholecystitis (7%), and gallstone pancreatitis (7%). Of the 29 patients who underwent ERCP, stent placement was successful in 26 (90%). Median follow-up was 9.4 months (range 0.1-40.5 months). Of those who had a stent placed, 6 (22%) subsequently underwent liver transplantation and another 15 (56%) were alive, most awaiting liver transplantation. Only 3 patients had late a complication or recurrence of biliary symptoms after stent placement. CONCLUSIONS: Endoscopic stent placement in the gallbladder is a safe and an effective palliative treatment for patients with symptoms caused by gallbladder disease who are poor surgical candidates.
Authors: Myung Soo Kang; Do Hyun Park; Ki Du Kwon; Jeong Hoon Park; Suck Ho Lee; Hong Soo Kim; Sang Heum Park; Sun Joo Kim Journal: World J Gastroenterol Date: 2007-03-07 Impact factor: 5.742
Authors: Sonia Gosain; Hugo Bonatti; LaVone Smith; Michele E Rehan; Andrew Brock; Anshu Mahajan; Melissa Phillips; Henry C Ho; Kristi Ellen; Vanessa M Shami; Michel Kahaleh Journal: Dig Dis Sci Date: 2009-11-04 Impact factor: 3.199
Authors: Thomas R McCarty; Kelly E Hathorn; Ahmad Najdat Bazarbashi; Kunal Jajoo; Marvin Ryou; Christopher C Thompson Journal: Surg Endosc Date: 2021-07-06 Impact factor: 4.584
Authors: Ali Siddiqui; Rastislav Kunda; Amy Tyberg; Mustafa A Arain; Arish Noor; Tayebah Mumtaz; Usama Iqbal; David E Loren; Thomas E Kowalski; Douglas G Adler; Monica Saumoy; Monica Gaidhane; Shawn Mallery; Eric M Christiansen; Jose Nieto; Michel Kahaleh Journal: Surg Endosc Date: 2018-09-12 Impact factor: 4.584