Comparison of the effectiveness and safety of lumen-apposing metal stents and anti-migrating tubular self-expandable metal stents for EUS-guided gallbladder drainage in high surgical risk patients with acute cholecystitis
- Authors
- Cho, Sung Hyun; Oh, Dongwook; Song, Tae Jun; Park, Do Hyun; Seo, Dong-Wan; Lee, Sung Koo; Kim, Myung-Hwan; Lee, Yun Nah; Moon, Jong Ho; Lee, Sang Soo
- Issue Date
- Mar-2020
- Publisher
- Mosby Inc.
- Keywords
- Comparison of the effectiveness and safety of lumen-apposing metal stents and anti-migrating tubular self-expandable metal stents for EUS-guided gallbladder drainage in high surgical risk patients with acute cholecystitis
- Citation
- Gastrointestinal Endoscopy, v.91, no.3, pp 543 - 550
- Pages
- 8
- Journal Title
- Gastrointestinal Endoscopy
- Volume
- 91
- Number
- 3
- Start Page
- 543
- End Page
- 550
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/3061
- DOI
- 10.1016/j.gie.2019.09.042
- ISSN
- 0016-5107
1097-6779
- Abstract
- Background and Aims: Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) using an anti-migrating tubular self-expandable metal stent (ATSEMS) is performed in high surgical risk patients with acute cholecystitis. The newly introduced lumen-apposing metal stent (LAMS) is expected to reduce the risk of tubular self-expandable metal stent-related adverse events such as stent migration, but no comparative studies have been carried out between LAMSs and ATSEMSs for EUS-GBD. Methods: We reviewed the prospectively collected EUS-GBD database at Asan Medical Center and Bucheon Soonchunhyang hospital to analyze consecutive patients with acute cholecystitis who underwent EUS-GBD with LAMSs or ATSEMSs between January 2015 and December 2017. Technical success, clinical success, adverse events, and recurrence of cholecystitis were evaluated. Results: A total of 71 patients (36 with LAMSs, 35 with ATSEMSs) were analyzed. The LAMS group had longer median procedure time (15.5 minutes) than the ATSEMS group (11 minutes; P = .017). The 2 groups did not show significant differences in terms of technical success (LAMS, 94% vs ATSEMS, 100%; P = .49), clinical success (94% vs 100%; P = .49), procedure-related adverse events (0% vs 2.9%; P = .99), and stent-related late adverse events (11.8% vs 5.8%; P = .43). During follow-up, the 2 groups had similar rates of cholecystitis recurrence at 6 months (LAMS, 3.4% vs ATSEMS, 3.1%, P = .99) and 12 months (8.3% vs 3.1%, P = .56). Conclusions: In high surgical risk patients with acute cholecystitis, LAMSs and ATSEMSs for EUS-GBD showed similar rates of technical success, clinical success, procedure-related adverse events, stent-related late adverse events, and recurrence of cholecystitis.
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