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Endoscopic ultrasound-guided gallbladder drainage for acute cholecystitis with a silicone-covered nitinol short bilaterally flared stent: a case series
BACKGROUND AND STUDY AIM: Gallbladder drainage in patients with cholecystitis who are unsuitable for surgery may be performed by endoscopic ultrasound (EUS)-guided placement of specifically designed fully covered metal stents. We describe the first case series of patients treated with a silicone-cov...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
© Georg Thieme Verlag KG
2017
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5677460/ https://www.ncbi.nlm.nih.gov/pubmed/29124119 http://dx.doi.org/10.1055/s-0043-118659 |
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author | Manta, Raffaele Zulli, Claudio Zullo, Angelo Forti, Edoardo Tringali, Alberto Dioscoridi, Lorenzo Zito, Francesco Bertani, Helga Conigliaro, Rita Mutignani, Massimiliano |
author_facet | Manta, Raffaele Zulli, Claudio Zullo, Angelo Forti, Edoardo Tringali, Alberto Dioscoridi, Lorenzo Zito, Francesco Bertani, Helga Conigliaro, Rita Mutignani, Massimiliano |
author_sort | Manta, Raffaele |
collection | PubMed |
description | BACKGROUND AND STUDY AIM: Gallbladder drainage in patients with cholecystitis who are unsuitable for surgery may be performed by endoscopic ultrasound (EUS)-guided placement of specifically designed fully covered metal stents. We describe the first case series of patients treated with a silicone-covered nitinol stent with bilateral anchor flanges. PATIENTS AND METHODS: Data from consecutive patients with acute cholecystitis who were deemed unsuitable candidates for surgery were collected. The stent placement procedure was performed in two tertiary endoscopy centers by four experienced endoscopists. Technical and clinical success rates, as well as adverse events and clinical outcome at follow-up, were assessed. RESULTS: EUS-guided drainage for cholecystitis was performed in 16 patients (mean age 84 years; nine males). Technical and clinical success rates were 100 % (16/16) and 94 % (15/16), respectively; an early failure due to stone impaction occurred in the remaining case and required placement of a new stent. Symptom relief occurred in 11/15 cases (73 %) within 1 day, and within 2 days in the remaining 4 patients. Bleeding occurred in two patients (13 %): in one patient intraprocedural bleeding was successfully stopped during endoscopy; and delayed bleeding occurred in one patient requiring arterial embolization for catastrophic bleeding (patient died 10 days later). No cases of cholecystitis recurrence or biliary obstruction were observed during a median follow-up of 112 days (range 49 – 180 days). CONCLUSIONS: Our data showed that EUS-guided gallbladder drainage with a specially designed stent is feasible and successful in patients with acute cholecystitis who are unfit for surgery. |
format | Online Article Text |
id | pubmed-5677460 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | © Georg Thieme Verlag KG |
record_format | MEDLINE/PubMed |
spelling | pubmed-56774602017-11-09 Endoscopic ultrasound-guided gallbladder drainage for acute cholecystitis with a silicone-covered nitinol short bilaterally flared stent: a case series Manta, Raffaele Zulli, Claudio Zullo, Angelo Forti, Edoardo Tringali, Alberto Dioscoridi, Lorenzo Zito, Francesco Bertani, Helga Conigliaro, Rita Mutignani, Massimiliano Endosc Int Open BACKGROUND AND STUDY AIM: Gallbladder drainage in patients with cholecystitis who are unsuitable for surgery may be performed by endoscopic ultrasound (EUS)-guided placement of specifically designed fully covered metal stents. We describe the first case series of patients treated with a silicone-covered nitinol stent with bilateral anchor flanges. PATIENTS AND METHODS: Data from consecutive patients with acute cholecystitis who were deemed unsuitable candidates for surgery were collected. The stent placement procedure was performed in two tertiary endoscopy centers by four experienced endoscopists. Technical and clinical success rates, as well as adverse events and clinical outcome at follow-up, were assessed. RESULTS: EUS-guided drainage for cholecystitis was performed in 16 patients (mean age 84 years; nine males). Technical and clinical success rates were 100 % (16/16) and 94 % (15/16), respectively; an early failure due to stone impaction occurred in the remaining case and required placement of a new stent. Symptom relief occurred in 11/15 cases (73 %) within 1 day, and within 2 days in the remaining 4 patients. Bleeding occurred in two patients (13 %): in one patient intraprocedural bleeding was successfully stopped during endoscopy; and delayed bleeding occurred in one patient requiring arterial embolization for catastrophic bleeding (patient died 10 days later). No cases of cholecystitis recurrence or biliary obstruction were observed during a median follow-up of 112 days (range 49 – 180 days). CONCLUSIONS: Our data showed that EUS-guided gallbladder drainage with a specially designed stent is feasible and successful in patients with acute cholecystitis who are unfit for surgery. © Georg Thieme Verlag KG 2017-11 2017-11-08 /pmc/articles/PMC5677460/ /pubmed/29124119 http://dx.doi.org/10.1055/s-0043-118659 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited. |
spellingShingle | Manta, Raffaele Zulli, Claudio Zullo, Angelo Forti, Edoardo Tringali, Alberto Dioscoridi, Lorenzo Zito, Francesco Bertani, Helga Conigliaro, Rita Mutignani, Massimiliano Endoscopic ultrasound-guided gallbladder drainage for acute cholecystitis with a silicone-covered nitinol short bilaterally flared stent: a case series |
title | Endoscopic ultrasound-guided gallbladder drainage for acute cholecystitis with a silicone-covered nitinol short bilaterally flared stent: a case series |
title_full | Endoscopic ultrasound-guided gallbladder drainage for acute cholecystitis with a silicone-covered nitinol short bilaterally flared stent: a case series |
title_fullStr | Endoscopic ultrasound-guided gallbladder drainage for acute cholecystitis with a silicone-covered nitinol short bilaterally flared stent: a case series |
title_full_unstemmed | Endoscopic ultrasound-guided gallbladder drainage for acute cholecystitis with a silicone-covered nitinol short bilaterally flared stent: a case series |
title_short | Endoscopic ultrasound-guided gallbladder drainage for acute cholecystitis with a silicone-covered nitinol short bilaterally flared stent: a case series |
title_sort | endoscopic ultrasound-guided gallbladder drainage for acute cholecystitis with a silicone-covered nitinol short bilaterally flared stent: a case series |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5677460/ https://www.ncbi.nlm.nih.gov/pubmed/29124119 http://dx.doi.org/10.1055/s-0043-118659 |
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