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Fumisato Kozakai,Yoshihide Kanno,Kei Ito,Shinsuke Koshita,Takahisa Ogawa,Hiroaki Kusunose,Kaori Masu,Toshitaka Sakai,Toji Murabayashi,Keisuke Yonamine,Yujiro Kawakami,Yuki Fujii,Kazuaki Miyamoto,Yutak 대한소화기내시경학회 2019 Clinical Endoscopy Vol.52 No.3
Background/Aims: It is often diffcult to manage acute cholecystitis after metal stent (MS) placement in unresectable malignant biliarystrictures. The aim of this study was to evaluate the feasibility of endoscopic ultrasonography-guided gallbladder drainage (EUS-GBD)for acute cholecystitis. Methods: The clinical outcomes of 10 patients who underwent EUS-GBD for acute cholecystitis after MS placement between January2011 and August 2018 were retrospectively evaluated. The procedural outcomes of percutaneous transhepatic gallbladder drainage(PTGBD) with tube placement (n=11 cases) and aspiration (PTGBA) (n=27 cases) during the study period were evaluated as a reference. Results: The technical success and clinical effectiveness rates of EUS-GBD were 90% (9/10) and 89% (8/9), respectively. Severe bileleakage that required surgical treatment occurred in one case. Acute cholecystitis recurred after stent dislocation in 38% (3/8) of thecases. Both PTGBD and PTGBA were technically successful in all cases without severe adverse events and clinically effective in 91% and63% of the cases, respectively. Conclusions: EUS-GBD after MS placement was a feasible option for treating acute cholecystitis. However, it was a rescue techniquefollowing the established percutaneous intervention in the current setting because of the immature technical methodology, includingdedicated devices, which need further development.