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

BMC Gastroenterology

Research Article

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

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

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

DOI  :  10.1186/1471-230X-13-65

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

来源: Springer

【 摘 要 】

BackgroundEndoscopic transpapillary pernasal gallbladder drainage and endoscopicgallbladder stenting (EGS) have recently been reported to be useful inpatients with acute cholecystitis for whom a percutaneous approach iscontraindicated. The aim of this study was to evaluate the efficacy ofpermanent EGS for management of acute cholecystitis in elderly patients whowere poor surgical candidates.MethodsWe retrospectively studied 46 elderly patients aged 65 years or older withacute cholecystitis who were treated at Japan Labour Health and WelfareOrganization Niigata Rosai Hospital. In 40 patients, acute cholecystitis wasdiagnosed by transabdominal ultrasonography and computed tomography, while 6patients were transferred from other hospitals after primary management ofacute cholecystitis. All patients underwent EGS, with a 7Fr double pig-tailstent being inserted into the gallbladder. If EGS failed, percutaneoustranshepatic gallbladder drainage or percutaneous transhepatic gallbladderaspiration was subsequently performed. The main outcome measure of thisstudy was the efficacy of EGS.ResultsPermanent 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 ofthese patients were cerebral infarction (n=14) and dementia (n=13). In 30 ofthese 31 patients (96.7%), there was no recurrence of cholecystitis and 29patients (93.5%) remained asymptomatic until death or the end of the studyperiod (after 1 month to 5 years).ConclusionsEGS can be effective for elderly patients with acute cholecystitis who arepoor surgical candidates and can provide a solution for several years.

【 授权许可】

CC BY   
© Maekawa et al.; licensee BioMed Central Ltd. 2013