Long-term management of recurrent cholecystitis after initial conservative treatment: Endoscopic transpapillary gallbladder stenting

Abstract

Background. Endoscopic transpapillary gallbladder stenting (ETGBS) is an effective procedure for treating high-risk patients with acute cholecystitis and severe comorbidities. However, the efficacy of ETGBS for recurrent cholecystitis (RC) remains unclear. This study aimed to explore its efficacy in patients with RC for whom cholecystectomy is contraindicated because of its high surgical risk. Methods. Data on 19 high-risk patients who had undergone ETGBS for RC after initial conservative therapy in our institution between June 2006 and May 2012 were retrospectively examined. The primary outcome was the clinical success rate, which was defined as no recurrences of acute cholecystitis after ETGBS until death or the end of the follow-up period. Secondary outcomes were technical success rate and adverse events (AEs). Results. The clinical success rate of ETGBS was 100%, the technical success rate 94.7%, and AE rate 5%: One patient developed procedure-related mild acute pancreatitis. The clinical courses of all patients were as follows: Four died of nonbiliary disease, and the remaining 15 were subsequently treated conservatively. The median duration of follow-up was 14.95 months (range 3-42 months). Conclusions. ETGBS is an effective alternative for managing RC in high-risk patients with severe comorbidities.