Endoscopic ultrasonography-guided gallbladder drainage (EUS-GBD) has been developed as an alternative drainage method in patients with acute cholangitis. Here, we describe two successful EUS-GBD cases and review the literature on this topic.
MethodsEUS-GBD was conducted using a curved linear array echoendoscope and a 19-gauge needle.
ResultsA 7-Fr double pigtail stent was successfully placed transgastrically in one patient and transduodenally in the other patient, without any serious early adverse events in either patient. No late complications or relapse of acute cholecystitis have been seen during the 3- to 6-month follow-up period.
ConclusionsEUS-GBD holds high potential as an alternative gallbladder decompression procedure. However, because current experience is limited, multicenter trials for the accurate evaluation of this procedure appear to be necessary in the near future.
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The authors are indebted to Prof. J. Patrick Barron of the Department of International Medical Communication of Tokyo Medical University for his review of this manuscript.
Author information Authors and AffiliationsDepartment of Gastroenterology and Hepatology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, Japan
Takao Itoi, Fumihide Itokawa & Toshio Kurihara
Correspondence to Takao Itoi.
Electronic supplementary materialBelow is the link to the electronic supplementary material.
Video Clip 1.Endoscopic ultrasonography (EUS)-guided cholecystoduodenostomy (Case 1). A 19-gauge needle was inserted into the enlarged gallbladder under real-time EUS visualization. The stylet was removed and contrast medium was injected to confirm that the tip of the needle was in the gallbladder. Then, a 0.035-inch guidewire was inserted into the outer sheath. Biliary catheters of up to 8-Fr are used for dilation of the cholecystoduodenal fistula. Finally, a 7-Fr double pigtail-type plastic stent was inserted into the gallbladder. Endoscopic imaging shows the transduodenal stent placement (MOV 8512 kb)
Video Clip 2.EUS-guided cholecystogastrostomy (Case 2). A 19-gauge needle was inserted into the enlarged gallbladder under real-time EUS visualization. The stylet was removed and contrast medium was injected to confirm that the tip of the needle was in the gallbladder; then a 0.035-inch guidewire was inserted into the outer sheath. For dilation of the cholecystoduodenal fistula, we used biliary catheters of up to 8 Fr. Finally, a 7-Fr double pigtail-type plastic stent was inserted into the gallbladder. Endoscopic imaging showed transgastric stent placement (MOV 12528 kb)
About this article Cite this articleItoi, T., Itokawa, F. & Kurihara, T. Endoscopic ultrasonography-guided gallbladder drainage: actual technical presentations and review of the literature (with videos). J Hepatobiliary Pancreat Sci 18, 282–286 (2011). https://doi.org/10.1007/s00534-010-0310-4
Published: 23 July 2010
Issue Date: March 2011
DOI: https://doi.org/10.1007/s00534-010-0310-4
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