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- W2807241376 abstract "Some patients with acute cholecystitis (AC) are not candidates for immediate cholecystectomy and undergo transpapillary gallbladder (GB) double pigtail stenting with either single stent (SS) or dual stent (DS) therapy. We hypothesized that both SS and DS therapy effectively treat AC and prevent recurrence in patients who do not undergo cholecystectomy. Retrospective analysis of consecutive patients with AC who underwent ERCP with attempted transpapillary GB stent placement at a tertiary referral center from 2008-2017. Patients who underwent same-hospitalization cholecystectomy after stent placement were excluded from analysis. Long-term success was defined as no recurrence of AC or need for interventional GB therapy during follow-up. 67 patients (37% female, mean age 69 years) underwent attempted GB stenting. GB stents were successfully placed in 64 (95%), and one adverse event occurred (severe post-ERCP pancreatitis). Of the 64 successful cases, 41 (64%) received SS therapy, and 23 (36%) underwent DS therapy [Figure 1]. AC resolved in all (immediate clinical success rate of 100%). Twenty-three patients underwent subsequent elective cholecystectomy. Of the remaining 41 patients, seven had GB stents electively removed after a mean of 104 days (range 58-195 days); 4 had recurrence of AC symptoms requiring intervention after a mean of 313 days (range 105-633 days) with long-term success in 3/7 (35%). In the remaining 34 GB stents were left in place indefinitely, and 1 developed recurrent AC treated by percutaneous GB drainage at 135 days (long-term success in 33/34, 97%, p=0.00006 comparing the stent removal and indefinite stenting groups). Among these 33 patients with long-term success, time to last follow-up or death (from unrelated causes) was mean of 213 days (range 39-1185 days) in the SS group and 360 days (range 15-1879 days) in the DS group. Transpapillary GB stent placement effectively treats AC. Among stented patients not undergoing subsequent elective cholecystectomy, recurrent AC is common after stent removal, but unlikely if stents are left in place indefinitely. SS and DS therapy appear similarly effective in this series." @default.
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- W2807241376 date "2018-06-01" @default.
- W2807241376 modified "2023-10-14" @default.
- W2807241376 title "Sa1343 TRANSPAPILLARY GALLBLADDER STENTING IS AN EFFECTIVE LONG-TERM PALLIATIVE THERAPY FOR ACUTE CHOLECYSTITIS" @default.
- W2807241376 doi "https://doi.org/10.1016/j.gie.2018.04.1494" @default.
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