Endoscopic transpapillary gallbladder drainage: Single center experience

Yıl 2018, Cilt: 26 Sayı: 3, 91 - 94, 28.12.2018

Mustafa Kaplan , Bülent Ödemiş Selçuk Dişibeyaz , Erkan Parlak , Erkin Öztaş , Volkan Gökbulut Orhan Coşkun

https://doi.org/10.17940/endoskopi.503040

Öz

Objective: In this study, we investigated the technical
and clinical success and complications of transpapillary gallbladder drainage
with endoscopic retrograde cholangiopancreatography in patients with gallbladder
or cystic duct related diseases accompanied by comorbid conditions.

Material
and Methods: This
study was performed on 19 patients with acute cholecystitis who had already an
indication for endoscopic retrograde cholangiopancreatography due to choledocholitiasis,
cholangitis or Mirizzi syndrome between 2011-2017. After choledochal and cystic
duct stones had been removed, or choledochal stents had been placed according
to indication, transpapillary gallbladder drainage with nasocystic drain or
pigtail stent were provided in all patients. The technical and clinical success of
transpapillary gallbladder drainage and the complications of the procedure were
evaluated.

Results:
15 (79%) of the patients had at
least one comorbid disease. Cystic duct stones were observed in 10 patients. Balloon lavage to all patients with cystic
duct stones, basket and mechanical lithotripsy to 3 patients, and balon
dilatation to the entrance of cystic duct to one patient were applied. Transpapillary
gallbladder drainage was provided with 7F nasocystic drain in 8 patients, stent
made from 7F nasobiliary drain in 6 patients, 7F double pigtail stent in 3
patients and 10F double pigtail stent in 2 patients. In this study, the technical success
of transpapillary gallbladder drainage was found 100% and clinical success was
found 89%. No complications including death were observed due to the procedure.

Conclusion:
Transpapillary gallbladder drainage with endoscopic
retrograde cholangiopancreatography is a successful and less complicated procedure
in patients who have gallbladder or cystic duct related diseases with comorbid
conditions.

Anahtar Kelimeler

Acute cholecystitis, gallbladder drainage, endoscopic retrograde cholangiopancreatography

Endoskopik transpapiller safra kesesi drenajı: Tek merkez deneyimi

Öz

Giriş
ve Amaç: Bu çalışmada
komorbit durumların eşlik ettiği sistik kanal veya safra kesesi ilişkili
hastalıklarda ERCP ile transpapiller safra kesesi drenajının teknik ve klinik
başarısını ve komplikasyonlarını araştırdık. Gereç ve Yöntem: Bu çalışma 2011-2017 yılları arasında koledok
taşı, kolanjit veya Mirizzi sendromu nedeniyle endoskopik retrograd kolanjiopankreotografi
endikasyonu zaten konulan ve eşlik eden akut kolesistiti olan toplam 19 hasta ile
yapıldı. Endikasyona göre koledok taşları ve sistik kanal taşları çıkarıldıktan
veya koledoğa stent yerleştirildikten sonra tüm hastalarda nazosistik dren veya
pigtail stent ile transpapiller safra kesesi drenajı sağlandı. Transpapiller
safra kesesi drenajının teknik ve klinik başarısı ve işlemin komplikasyonları
değerlendirildi. Bulgular: Hastaların 15’inde (%79) en az bir komorbid hastalık vardı.
10 hastada sistik kanalda taş izlendi. Sistik kanalında taş olan tüm hastalara
balon ile lavaj, 3 hastaya basket ve mekanik litotripsi ve bir hastaya da
sistik kanal girişine balon dilatasyonu uygulandı. Transpapiller safra kesesi
drenajı 8 hastada 7F nazosistik dren, 6 hastada 7F nazobiliyer drenden yapılma
stent, 3 hastada 7F double pigtail stent ve 2 hastada 10F double pigtail stent
ile sağlandı. Çalışmada transpapiller safra kesesi drenajının teknik başarısı
%100 ve klinik başarısı %89 olarak bulundu. İşleme bağlı ölüm dahil herhangi
bir komplikasyon görülmedi. Sonuç: Komorbit durumların eşlik ettiği safra
kesesi veya sistik kanal ile ilişkili hastalıklarda endoskopik retrograd kolanjiopankreotografi
ile transpapiller safra kesesi drenajı başarılı ve komplikasyonu az bir
yöntemdir.

Anahtar Kelimeler

Akut kolesistit, safra kesesi drenajı, endoskopik retrograd kolanjiopankreotografi

Kaynakça

• 1- Ogura T, Higuchi K. A review of treatment options for bile duct stones. Expert Rev Gastroenterol Hepatol 2016;10:1271-8.
• 2- Williams E, Beckingham I, El Sayed G, et al. Updated guideline on the management of common bile duct stones (CBDS). Gut 2017;66:765-82.
• 3- Paranandi B, Oppong KW. Biliary strictures: endoscopic assessment and management. Frontline Gastroenterol 2017;8:133-7.
• 4- ASGE Standards of Practice Committee, Chathadi KV, Chandrasekhara V, Acosta RD, et al. The role of ERCP in benign diseases of the biliary tract. Gastrointest Endosc 2015;81:795-803.
• 5- Valderrama-Treviño AI, Granados-Romero JJ, Espejel-Deloiza M et al. Updates in Mirizzi syndrome. Hepatobiliary Surg Nutr 2017;6:170-8.
• 6- Glessing BR, Attam R, Amateau SK, et al. Novel use of long, large caliber, fenestrated stents for endoscopic transpapillary gallbladder stenting for therapy of symptomatic gallbladder disease. Dig Dis Sci 2015;60:3817-22.
• 7- Widmer J, Alvarez P, Sharaiha RZ, et al. Endoscopic gallbladder drainage for acute cholecystitis. Clin Endosc 2015;48:411-20.
• 8- Talukdar R. Complications of ERCP. Best Pract Res Clin Gastroenterol 2016;30:793-805.
• 9- Hasan MK, Itoi T, Varadarajulu S. Endoscopic management of acute cholecystitis. Gastrointest Endosc Clin N Am 2013;23:453-9.
• 10-Maekawa S1, Nomura R, Murase T, et al. Endoscopic gallbladder stenting for acute cholecystitis: a retrospective study of 46 elderlypatients aged 65 years or older. BMC Gastroenterol 2013;13:65.
• 11-Valderrama-Treviño AI, Granados-Romero JJ, Espejel-Deloiza M et al. Updates in Mirizzi syndrome. Hepatobiliary Surg Nutr 2017;6:170-8.