CC BY-NC-ND 4.0 · Endosc Int Open 2019; 07(08): E964-E973
DOI: 10.1055/a-0915-2098
Original article
Owner and Copyright © Georg Thieme Verlag KG 2019

Outcomes of an international multicenter registry on EUS-guided gallbladder drainage in patients at high risk for cholecystectomy[*]

A.Y. Teoh
 1   Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
,
Manuel Perez-Miranda
 2   Department of Medicine, University Hospital Rio Hortega, Valladolid, Spain
,
Rastislav Kunda
 3   Department of Surgical Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
,
Sang Soo Lee
 4   Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
,
Shayan Irani
 5   Digestive Disease Institute, Virginia Mason Medical Center, Seattle, Washington, United States
,
Paul Yeaton
 6   Department of Gastroenterology, Carilion Clinic, Roanoke, Virginia, United States
,
Siyu Sun
 7   Endoscopy Center, Shengjing Hospital of China Medical University, Shenyang, China
,
Todd Huntley Baron
 8   Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
,
Jong Ho Moon
 9   Department of Internal Medicine, SoonChunHyang University College of Medicine, Bucheon Hospital, Bucheon/Seoul, Republic of Korea
,
Bronte Holt
10   Division of Gastroenterology, St Vincentʼs Hospital, Melbourne, Australia
,
Christopher J.L. Khor
11   Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore
,
Rungsun Rerknimitr
12   Division of Gastroenterology, Department of Medicine, King Chulalongkorn Memorial Hospital, Bangkok
,
Amol Bapaye
13   Shivanand Desai Center for Digestive Disorders, Deenanath Mangeshkar Hospital and Research Center, India
,
Shannon Melissa Chan
 1   Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
,
Hyun Jong Choi
 9   Department of Internal Medicine, SoonChunHyang University College of Medicine, Bucheon Hospital, Bucheon/Seoul, Republic of Korea
,
Theodore William James
 8   Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
,
Pradermchai Kongkam
12   Division of Gastroenterology, Department of Medicine, King Chulalongkorn Memorial Hospital, Bangkok
,
Yun Nah Lee
 9   Department of Internal Medicine, SoonChunHyang University College of Medicine, Bucheon Hospital, Bucheon/Seoul, Republic of Korea
,
Parth Parekh
14   Eastern Virginia Medical School, Norfolk, Virginia, United States
,
Wiriyaporn Ridtitid
12   Division of Gastroenterology, Department of Medicine, King Chulalongkorn Memorial Hospital, Bangkok
,
Carlos Serna-Higuera
 2   Department of Medicine, University Hospital Rio Hortega, Valladolid, Spain
,
Damien M.Y. Tan
11   Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore
,
Raul Torres-Yuste
 2   Department of Medicine, University Hospital Rio Hortega, Valladolid, Spain
› Institutsangaben
Weitere Informationen

Publikationsverlauf

submitted 23. Februar 2019

accepted after revision 10. April 2019

Publikationsdatum:
24. Juli 2019 (online)

Abstract

Background and study aims The aim of the current study was to review the outcomes of a large-scale international registry on endoscopic ultrasound-guided gallbladder drainage (EGBD) that encompasses different stent systems in patients who are at high-risk for cholecystectomy.

Patients and methods This was a retrospective international multicenter registry on EGBD created by 13 institutions around the world. Consecutive patients who received EGBD for several indications were included. Outcomes include technical and clinical success, unplanned procedural events (UPE), adverse events (AEs), mortality, recurrent cholecystitis and learning curve of the procedure.

Results Between June 2011 and November 2017, 379 patients were recruited to the study. Technical and clinical success were achieved in 95.3 % and 90.8 % of the patients, respectively. The 30-day AE rate was 15.3 % and 30-day mortality was 9.2 %. UPEs were significantly more common in patients with EGBD performed for conversion of cholecystostomy and symptomatic gallstones (P < 0.001); and by endoscopists with experience of fewer than 25 procedures (P = 0.033). Both presence of clinical failure (P = 0.014; RR 8.69 95 %CI [1.56 – 48.47]) and endoscopist experience with fewer than 25 procedures (P = 0.002; RR 4.68 95 %CI [1.79 – 12.26]) were significant predictors of 30-day AEs. Presence of 30-day AEs was a significant predictor of mortality (P < 0.001; RR 103 95 %CI [11.24 – 944.04]).

Conclusion EGBD was associated with high success rates in this large-scale study. EGBD performed for indications other than acute cholecystitis was associated with higher UPEs. The number of cases required to gain competency with the technique by experienced interventional endosonographers was 25 procedures.

* Meeting presentations: Digestive Disease Week 2018


 
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