Background and Aims
Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) using an anti-migrating tubular self-expandable metal stent (ATSEMS) is performed in high surgical risk patients with acute cholecystitis. The newly introduced lumen-apposing metal stent (LAMS) is expected to reduce the risk of tubular self-expandable metal stent–related adverse events such as stent migration, but no comparative studies have been carried out between LAMSs and ATSEMSs for EUS-GBD.
We reviewed the prospectively collected EUS-GBD database at Asan Medical Center and Bucheon Soonchunhyang hospital to analyze consecutive patients with acute cholecystitis who underwent EUS-GBD with LAMSs or ATSEMSs between January 2015 and December 2017. Technical success, clinical success, adverse events, and recurrence of cholecystitis were evaluated.
A total of 71 patients (36 with LAMSs, 35 with ATSEMSs) were analyzed. The LAMS group had longer median procedure time (15.5 minutes) than the ATSEMS group (11 minutes; P = .017). The 2 groups did not show significant differences in terms of technical success (LAMS, 94% vs ATSEMS, 100%; P = .49), clinical success (94% vs 100%; P = .49), procedure-related adverse events (0% vs 2.9%; P = .99), and stent-related late adverse events (11.8% vs 5.8%; P = .43). During follow-up, the 2 groups had similar rates of cholecystitis recurrence at 6 months (LAMS, 3.4% vs ATSEMS, 3.1%, P = .99) and 12 months (8.3% vs 3.1%, P = .56).
In high surgical risk patients with acute cholecystitis, LAMSs and ATSEMSs for EUS-GBD showed similar rates of technical success, clinical success, procedure-related adverse events, stent-related late adverse events, and recurrence of cholecystitis.
Abbreviations:ATSEMS (anti-migrating tubular self-expandable metal stent), EUS-GBD (endoscopic ultrasound-guided gallbladder drainage), IQR (interquartile range), LAMS (lumen-apposing metal stent), PTC (percutaneous cholecystostomy)
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Published online: October 17, 2019
Accepted: September 27, 2019
Received: June 12, 2019
DISCLOSURE: All authors disclosed no financial relationships.
© 2020 by the American Society for Gastrointestinal Endoscopy
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- Role of different types of stents in EUS-guided gallbladder drainageGastrointestinal EndoscopyVol. 91Issue 4
- PreviewWe read with great interest the original article “Comparison of the effectiveness and safety of lumen-apposing metal stent and antimigrating tubular self-expandable metal stent for EUS-guided gallbladder drainage in high surgical risk patients with acute cholecystitis,” by Cho et al.1 In this retrospective study, the authors concluded that lumen-apposing metal stents (LAMSs) and antimigrating tubular self-expandable metal stents (ATSEMSs) for EUS-guided gallbladder drainage (EUS-GBD) showed similar success rates, procedure-related adverse events, and cholecystitis recurrence.