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EUS-guided cholecystenterostomy: a new technique (with videos).

Abstract：

BACKGROUND:The cornerstone of management for acute cholecystitis is cholecystectomy. However, surgical intervention is contraindicated in the occasional patient. EUS-guided transduodenal gallbladder drainage may represent an effective minimally invasive alternative. OBJECTIVES:To describe a new technique, EUS-guided cholecystenterostomy. DESIGN AND SETTING:A single-center retrospective case series. PATIENTS:Three patients with severe acute cholecystitis unresponsive to conservative management who were deemed unfit for cholecystectomy. INTERVENTIONS:Under combined EUS and fluoroscopic guidance, cholecystenterostomy was performed via needle puncture, guidewire insertion, cystoenterostome passage, and stent placement. MAIN OUTCOME MEASURES:Technical success, clinical progress, immediate and long-term complications, and recurrence of cholecystitis. LIMITATIONS:Pilot series. RESULTS:Cholecystenterostomy was performed successfully in all patients. Rapid improvement in clinical status and inflammatory parameters ensued. A minor intraprocedural bile leak occurred in 1 patient, without significant clinical sequelae. Cholecystitis did not recur in any patient. CONCLUSIONS:EUS-guided cholecystenteric drainage is technically feasible and appears to be a safe and effective procedure. Via this technique, gallbladder drainage and resolution of related sepsis may be achieved in patients with acute cholecystitis who are unfit for surgery.

journal_name

Gastrointest Endosc

journal_title

Gastrointestinal endoscopy

authors

Kwan V,Eisendrath P,Antaki F,Le Moine O,Devière J

doi

10.1016/j.gie.2007.02.065

subject

Has Abstract

pub_date

2007-09-01 00:00:00

pages

582-6

issue

3

eissn

0016-5107

issn

1097-6779

pii

S0016-5107(07)00407-5

journal_volume

66

pub_type

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