Feasibility of a novel 5-Fr plastic stent in endoscopic transpapillary gallbladder drainage for acute cholecystitis

Abstract

Background and study aims: Many reports have demonstrated the efficacy of endoscopic transpapillary gallbladder stenting (EGBS) for acute cholecystitis (AC), most of which have traditionally used a 7-Fr plastic stent. The study aim was to evaluate the efficacy of a novel 5-Fr plastic stent in EGBS for AC. Patients and methods: We designed a retrospective study that compared the outcomes between 7-Fr and 5-Fr stents in patients undergoing EGBS. Among 147 patients who underwent endoscopic transpapillary gallbladder drainage for AC between January 2019 and July 2023, 104 who underwent EGBS using a 7-Fr (n = 53) or 5-Fr (n = 51) plastic stent were included in the analysis. Results: The technical success rate of EGBS, clinical success rate for AC, and early adverse events (AEs) rate in the 7-Fr and 5-Fr groups were 92.5% vs 100%, 100% vs 98.0%, and 5.7% vs 3.9%, respectively, with no significant differences. However, only in the 7-Fr group, 4 patients failed stent insertion and 3 patients developed postprocedural pancreatitis. Furthermore, the incidence of hyperamylasemia was lower in the 5-Fr group (24.5% vs 9.8%, P = 0.047). The late AE rate did not differ significantly between the 7-Fr and 5-Fr group (14.3% vs 10.0%). The median time to late AE was 238 days for the 7-Fr group and 187 days for the 5-Fr group, with no significant difference. Conclusions: A 5-Fr stent can provide outcomes comparable to those of a 7-Fr stent and help prevent hyperamylasemia.