Clinical Endoscopy

  • 제55권6호
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  • Pages.784-792
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  • 2022
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  • 2234-2400(pISSN)
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  • 2234-2443(eISSN)
대한소화기내시경학회 (The Korean Society of Gastrointestinal Endoscopy)
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The feasibility of percutaneous transhepatic gallbladder aspiration for acute cholecystitis after self-expandable metallic stent placement for malignant biliary obstruction: a 10-year retrospective analysis in a single center

  • Akihisa Ohno (Department of Gastroenterology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center) ;
  • Nao Fujimori (Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University) ;
  • Toyoma Kaku (Department of Gastroenterology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center) ;
  • Masayuki Hijioka (Department of Gastroenterology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center) ;
  • Ken Kawabe (Department of Gastroenterology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center) ;
  • Naohiko Harada (Department of Gastroenterology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center) ;
  • Makoto Nakamuta (Department of Gastroenterology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center) ;
  • Takamasa Oono (Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University) ;
  • Yoshihiro Ogawa (Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University)
  • 투고 : 2021.07.27
  • 심사 : 2022.02.25
  • 발행 : 2022.11.30
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초록

Background/Aims: Patients with acute cholecystitis (AC) after metallic stent (MS) placement for malignant biliary obstruction (MBO) have a high surgical risk. We performed percutaneous transhepatic gallbladder aspiration (PTGBA) as the first treatment for AC. We aimed to identify the risk factors for AC after MS placement and the poor response factors of PTGBA. Methods: We enrolled 401 patients who underwent MS placement for MBO between April 2011 and March 2020. The incidence of AC was 10.7%. Of these 43 patients, 37 underwent PTGBA as the first treatment. The patients' responses to PTGBA were divided into good and poor response groups. Results: There were 20 patients in good response group and 17 patients in poor response group. Risk factors for cholecystitis after MS placement included cystic duct obstruction (p<0.001) and covered MS (p<0.001). Cystic duct obstruction (p=0.003) and uncovered MS (p=0.011) demonstrated significantly poor responses to PTGBA. Cystic duct obstruction is a risk factor for cholecystitis and poor response factor for PTGBA, whereas covered MS is a risk factor for cholecystitis and an uncovered MS is a poor response factor of PTGBA for cholecystitis. Conclusions: The onset and poor response factors of AC after MS placement were different between covered and uncovered MS. PTGBA can be a viable option for AC after MS placement, especially in patients with covered MS.

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참고문헌

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