Feasibility of per-oral cholecystoscopy and advanced gallbladder interventions after EUS-guided gallbladder stenting (with video)

Gastrointest Endosc. 2017 Jun;85(6):1225-1232. doi: 10.1016/j.gie.2016.10.014. Epub 2016 Oct 15.

Abstract

Background and aims: The recent development of EUS-guided gallbladder drainage (EGBD) with a lumen-apposing stent has made endoscopic assessment and advanced gallbladder interventions via the stent possible. The aim of this study was to assess the feasibility and safety of per-oral cholecystoscopy and the types of gallbladder interventions that can be performed.

Methods: This was a retrospective review conducted in the Prince of Wales Hospital from June 2012 to March 2016. All patients who had acute cholecystitis with EGBD were included. Cholecystoscopy was performed 1 to 3 months after stent insertion. Patients' demographic data, technical success, types of intervention, and adverse events were recorded.

Results: Twenty-nine cholecystoscopies were performed in 25 patients. Twenty-seven of 29 cholecystoscopies were successful (93.1%). Magnifying endoscopy was performed in 10 patients, confocal endomicroscopy and EUS in 1 patient, and endocytoscopy in another patient. Fourteen patients (56%) had spontaneous stone passage. Eleven patients (44%) had residual gallstones on cholecystoscopy, and removed in 8. Overall stone clearance rate was 88% after a mean (standard deviation) number of 1.25 (0.46) sessions of cholecystoscopy.

Conclusions: Per-oral cholecystoscopy and advanced gallbladder interventions were feasible and safe. This opens up exciting possibilities for endoscopic treatment of gallbladder pathologies.

Publication types

  • Video-Audio Media

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cholecystitis / diagnostic imaging
  • Cholecystitis / surgery*
  • Cholecystolithiasis / diagnostic imaging
  • Cholecystolithiasis / surgery*
  • Cholecystostomy / methods*
  • Drainage / methods*
  • Endoscopy / methods*
  • Endosonography
  • Feasibility Studies
  • Female
  • Gallbladder / diagnostic imaging
  • Gallbladder / surgery*
  • Humans
  • Intravital Microscopy
  • Male
  • Microscopy, Confocal
  • Natural Orifice Endoscopic Surgery
  • Retrospective Studies
  • Stents*
  • Surgery, Computer-Assisted