Endoscopic gallbladder stenting prevents recurrent cholecystitis among patients with deferred cholecystectomy: Study

According to a study published in Gastroenterology, Endoscopic transpapillary gallbladder stenting or ETGS can help prevent recurrent cholecystitis in acute cholecystitis patients with Common bile duct stones who have deferred cholecystectomy for three months. Most recurrences occurred within three months in those who did not receive ETGS.

Endoscopic transpapillary gallbladder stenting (ETGS) has been proposed as one of the adjunctive treatments, apart from antibiotics, before surgery in patients with acute cholecystitis whose cholecystectomy could not be performed or deferred.

ETGS has emerged as an alternative treatment for acute cholecystitis patients who cannot undergo or delay cholecystectomy. Although ETGS has been suggested as an adjunct to antibiotics, there is currently no data comparing its outcomes in patients who receive it versus those who do not. The objective of the present study is to evaluate the recurrent cholecystitis rates at 3 and 6 months in these two groups.

Between 2020-2023, eligible acute-calculous-cholecystitis patients (n=120) with a high probability of CBD stone, who were surgical candidates but could not have an early cholecystectomy during COVID-19 surgical lockdown, were randomized into groups A and B with 60 patients each. Group A received ETGS, and B did not. A definitive cholecystectomy was performed at three months or later in both groups.
Group A’s technical and clinical success rates were 90% and 100%, respectively. Based on intention-to-treat analysis, group A had a lower recurrence rate than group B at three months. At 3-6 months, group A showed a non-significantly lower rate of recurrent cholecystitis than group B.
Endoscopic transpapillary gallbladder stenting (ETGS) can effectively prevent recurrent cholecystitis in acute cholecystitis patients with CBD stones who have deferred cholecystectomy for three months. It is worth noting that most recurrences occur within the first three months after the procedure in patients who do not receive ETGS.
Reference:
Ridtitid, W., Karuehardsuwan, J., Faknak, N., Piyachaturawat, P., Vongwattanakit, P., Kulpatcharapong, S., Angsuwatcharakon, P., Mekaroonkamol, P., Kongkam, P., & Rerknimitr, R. (2024). Endoscopic gallbladder stenting to prevent recurrent cholecystitis in deferred cholecystectomy: a randomized trial. Gastroenterology. https://doi.org/10.1053/j.gastro.2024.02.007
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