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Safety and clinical outcomes of endoscopic ultrasound-guided gallbladder drainage with lumen-apposing metal stents in patients with dwell time over one year. | LitMetric

Safety and clinical outcomes of endoscopic ultrasound-guided gallbladder drainage with lumen-apposing metal stents in patients with dwell time over one year.

Ann Gastroenterol

Gastroenterology Department, Hospital Universitario Río Hortega, Valladolid (Raúl Torres Yuste, Francisco Javier García-Alonso, Ramón Sánchez-Ocana, Ana Yaiza Carbajo, Marina De Benito Sanz, Carlos De la Serna Higuera, Manuel Pérez-Miranda).

Published: June 2019

AI Article Synopsis

  • Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) is effective for treating high-risk cholecystitis patients, though long-term risks are unclear.* -
  • A study evaluated 22 patients, mostly elderly, who underwent EUS-GBD with lumen-apposing metal stents (LAMS), finding no adverse events after the first year and minimal gallstone-related hospital admissions.* -
  • The results suggest EUS-GBD with LAMS may serve as a long-term treatment option for acute cholecystitis in patients who cannot undergo traditional surgery.*

Article Abstract

Background: Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) has proved effective in patients with cholecystitis at high surgical risk. The long-term risks of gallstone-related disease and stent-related adverse events are unknown.

Methods: We performed a retrospective evaluation of a case series including subjects who underwent EUS-GBD using lumen-apposing metal stents (LAMS). Patients were identified from a prospective LAMS registry at a single tertiary center. Patients with a stent indwell time <1 year were excluded. Data regarding stent deployment and adverse events were retrieved from the prospective LAMS registry, while emergency room visits, admissions and causes of death were retrieved from electronic medical records.

Results: We included 22 patients with a median age of 88.3 years (interquartile range [IQR]: 82.6-92.7), 14 (63.6%) were male. Median follow up was 24.4 months (IQR: 18.2-42.4) and median time to the last available imaging procedure was 607 days (IQR: 463-938). No LAMS-related adverse events were identified beyond the first year of follow up. During follow up, 12 patients (54.5%) visited the emergency room 34 times (1 visit/patient, IQR: 0-3) and a total of 36 hospital admissions were required, with a median of 1 admission/patient (IQR: 0-3). Fourteen (63.6%) patients died during follow up. Only 1 patient (4.5%) required new hospital admissions for gallstone-related disease.

Conclusions: There were no adverse events beyond the first year after stent deployment, with only 4.5% of subjects requiring gallstone-related admissions. Permanent EUS-GBD with LAMS may be a definitive treatment for acute cholecystitis in patients ineligible for cholecystectomy.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6686095PMC
http://dx.doi.org/10.20524/aog.2019.0395DOI Listing

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