Efficacy and safety of endoscopic ultrasound‐guided gallbladder drainage without dilation by using a 0.035‐inch stiff guidewire

Abstract

Abstract Endoscopic ultrasound‐guided gallbladder drainage for patients with cholecystitis and high surgical risk is commonly performed by dilating the fistula before inserting the delivery sheath; however, this carries an increased risk of peritonitis. To overcome this problem, we developed a new technique that did not require dilation, using a 0.035‐inch stiff guidewire, and retrospectively evaluated the efficacy and safety of this technique. This retrospective case series report collected data on non‐surgical patients who underwent endoscopic ultrasound‐guided gallbladder drainage for various indications at Steel Memorial Muroran Hospital between November 2020 and October 2022. A total of 71 patients were included (mean age 83 ± 7.6 years; 33 women and 38 men). Breakthrough of the delivery sheath without dilation of the fistula was successful in 97.2% (n = 69) of patients. The success rate of stent placement was 98.6% (n = 70), as was the clinical success rate. Complications occurred in 2.8% (n = 2) of patients. Early and late adverse events occurred in 2.8% (n = 2) and 12.7% (n = 9) of patients, respectively. The mean procedure time was 24.8 ± 9.3 min. If a 0.035‐inch stiff guidewire is used, the dilation procedure can be omitted in the endoscopic ultrasound‐guided gallbladder drainage using self‐expandable metal stents.

Keywords

• acute cholecystitis
• endoscopy
• dilation
• drainage
• stents