PMID- 37059367
OWN - NLM
STAT- MEDLINE
DCOM- 20230821
LR  - 20230830
IS  - 1097-6779 (Electronic)
IS  - 0016-5107 (Linking)
VI  - 98
IP  - 3
DP  - 2023 Sep
TI  - Comparison of the long-term outcomes of EUS-guided gallbladder drainage and 
      endoscopic transpapillary gallbladder drainage for calculous cholecystitis in 
      poor surgical candidates: a multicenter propensity score-matched analysis.
PG  - 362-370
LID - S0016-5107(23)00375-9 [pii]
LID - 10.1016/j.gie.2023.04.002 [doi]
AB  - BACKGROUND AND AIMS: Although long-term stent placement using endoscopic 
      transpapillary gallbladder drainage (ETGBD) and EUS-guided gallbladder drainage 
      (EUS-GBD) reportedly reduces cholecystitis recurrence, comparative evidence of 
      their safety and efficacy is scarce. This study aimed to examine and compare the 
      long-term utility of EUS-GBD versus that of ETGBD in poor surgical candidates. 
      METHODS: A total of 379 high-risk surgical patients with acute calculous 
      cholecystitis met the eligibility criteria for enrollment in this study. The 
      technical success and adverse events (AEs) were compared between the EUS-GBD and 
      ETGBD groups, and propensity score matching was performed to adjust for 
      differences between the groups. Both groups underwent plastic stent placement, 
      and scheduled stent exchange and removal were not performed in either group. 
      RESULTS: The technical success rate of EUS-GBD was significantly higher than that 
      of ETGBD (96.7% vs 78.9%, P < .001), whereas the early AE rate did not differ 
      significantly between the 2 methods (7.8% vs 8.9%, P = 1.000). The rate of 
      recurrent cholecystitis did not differ significantly (3.8% vs 3.0%, P = 1.000), 
      but the rate of symptomatic late AEs, in addition to cholecystitis, was 
      significantly lower with EUS-GBD than with ETGBD (1.3% vs 13.4%, P = .006). 
      Consequently, the overall late AE rate was significantly lower with EUS-GBD (5.0% 
      vs 16.4%, P = .029). Multivariate analysis revealed that EUS-GBD was associated 
      with a significantly longer time to late AE (hazard ratio, .26; 95% confidence 
      interval, .10-.67; P = .005). CONCLUSIONS: Long-term stent placement via EUS-GBD 
      is a promising potential option for limiting late AEs, including recurrence, in 
      poor surgical candidates with calculous cholecystitis.
CI  - Copyright (c) 2023 American Society for Gastrointestinal Endoscopy. Published by 
      Elsevier Inc. All rights reserved.
FAU - Inoue, Tadahisa
AU  - Inoue T
AD  - Department of Gastroenterology, Aichi Medical University, Yazakokarimata, 
      Nagakute, Aichi, Japan. Electronic address: tinoue-tag@umin.ac.jp.
FAU - Yoshida, Michihiro
AU  - Yoshida M
AD  - Department of Gastroenterology and Metabolism, Nagoya City University Graduate 
      School of Medical Sciences, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 
      Japan.
FAU - Suzuki, Yuta
AU  - Suzuki Y
AD  - Department of Gastroenterology, Gifu Prefectural Tajimi Hospital, Maehata-cho, 
      Tajimi, Gifu, Japan.
FAU - Kitano, Rena
AU  - Kitano R
AD  - Department of Gastroenterology, Aichi Medical University, Yazakokarimata, 
      Nagakute, Aichi, Japan.
FAU - Urakabe, Kenji
AU  - Urakabe K
AD  - Department of Gastroenterology, Gifu Prefectural Tajimi Hospital, Maehata-cho, 
      Tajimi, Gifu, Japan.
FAU - Haneda, Kenichi
AU  - Haneda K
AD  - Department of Gastroenterology, Gifu Prefectural Tajimi Hospital, Maehata-cho, 
      Tajimi, Gifu, Japan.
FAU - Okumura, Fumihiro
AU  - Okumura F
AD  - Department of Gastroenterology, Gifu Prefectural Tajimi Hospital, Maehata-cho, 
      Tajimi, Gifu, Japan.
FAU - Naitoh, Itaru
AU  - Naitoh I
AD  - Department of Gastroenterology and Metabolism, Nagoya City University Graduate 
      School of Medical Sciences, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 
      Japan.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20230412
PL  - United States
TA  - Gastrointest Endosc
JT  - Gastrointestinal endoscopy
JID - 0010505
SB  - IM
MH  - Humans
MH  - Gallbladder/surgery/diagnostic imaging
MH  - Propensity Score
MH  - Endosonography/methods
MH  - *Cholecystitis/surgery/etiology
MH  - *Cholecystitis, Acute/surgery/etiology
MH  - Drainage/methods
MH  - Stents
COIS- Disclosure The authors declare no conflicts of interest for this study.
EDAT- 2023/04/15 06:00
MHDA- 2023/08/21 06:42
CRDT- 2023/04/14 19:29
PHST- 2022/12/14 00:00 [received]
PHST- 2023/03/18 00:00 [revised]
PHST- 2023/04/05 00:00 [accepted]
PHST- 2023/08/21 06:42 [medline]
PHST- 2023/04/15 06:00 [pubmed]
PHST- 2023/04/14 19:29 [entrez]
AID - S0016-5107(23)00375-9 [pii]
AID - 10.1016/j.gie.2023.04.002 [doi]
PST - ppublish
SO  - Gastrointest Endosc. 2023 Sep;98(3):362-370. doi: 10.1016/j.gie.2023.04.002. Epub 
      2023 Apr 12.