Endoscopic gallbladder stenting for acute cholecystitis: a retrospective study of46 elderly patients aged 65 years or older

BMC Gastroenterology

Masaru Harada²  Masayuki Oeholm¹  Yasuyoshi Ann¹  Takayuki Murase¹  Ryosuke Nomura¹  Satoshi Maekawa¹ 

[1] Department of Gastroenterological Medicine, Japan Labour Health and WelfareOrganization Niigata Rosai Hospital, 1-7-12 Touncho, Joetsu, Niigata,942-8502, Japan;Third Department of Internal Medicine, University of Occupational andEnvironmental Health, 1-1 Iseigaoka, Yahata-nishi-ku, Kitakyushu, Fukuoka,807-8555, Japan

关键词: Elderly patients;    Endoscopic transpapillary naso-gallbladder drainage;    percutaneous transhepatic gallbladder aspiration;    Percutaneous transhepatic gallbladder drainage;    Cholecystitis;    Endoscopic gallbladder stenting;   

Others  :  858063
DOI  :  10.1186/1471-230X-13-65

 received in 2012-12-06, accepted in 2013-04-10,  发布年份 2013

【 摘 要 】

Background

Endoscopic transpapillary pernasal gallbladder drainage and endoscopic gallbladder stenting (EGS) have recently been reported to be useful in patients with acute cholecystitis for whom a percutaneous approach is contraindicated. The aim of this study was to evaluate the efficacy of permanent EGS for management of acute cholecystitis in elderly patients who were poor surgical candidates.

Methods

We retrospectively studied 46 elderly patients aged 65 years or older with acute cholecystitis who were treated at Japan Labour Health and Welfare Organization Niigata Rosai Hospital. In 40 patients, acute cholecystitis was diagnosed by transabdominal ultrasonography and computed tomography, while 6 patients were transferred from other hospitals after primary management of acute cholecystitis. All patients underwent EGS, with a 7Fr double pig-tail stent being inserted into the gallbladder. If EGS failed, percutaneous transhepatic gallbladder drainage or percutaneous transhepatic gallbladder aspiration was subsequently performed. The main outcome measure of this study was the efficacy of EGS.

Results

Permanent EGS was successful in 31 patients (77.5%) with acute cholecystitis, without any immediate postprocedural complications such as pancreatitis, bleeding, perforation, or cholangitis. The most common comorbidities of these patients were cerebral infarction (n=14) and dementia (n=13). In 30 of these 31 patients (96.7%), there was no recurrence of cholecystitis and 29 patients (93.5%) remained asymptomatic until death or the end of the study period (after 1 month to 5 years).

Conclusions

EGS can be effective for elderly patients with acute cholecystitis who are poor surgical candidates and can provide a solution for several years.

【 授权许可】

   
2013 Maekawa et al.; licensee BioMed Central Ltd.

【 图 表 】

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