Factors predicting technical failure of endoscopic transpapillary gallbladder drainage for acute cholecystitis

Abstract Objectives Endoscopic transpapillary gallbladder drainage (ETGBD) is a highly technical procedure, but few studies have evaluated factors that predict its technical success. Therefore, in this study, we sought to identify predictors of technically successful ETGBD. Methods One hundred and e...

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Main Authors: Noriyuki Hirakawa, Kenjiro Yamamoto, Atsushi Sofuni, Takayoshi Tsuchiya, Kentaro Ishii, Reina Tanaka, Ryosuke Tonozuka, Shuntaro Mukai, Kazumasa Nagai, Yukitoshi Matsunami, Hiroyuki Kojima, Hirohito Minami, Ryosuke Nakatsubo, Kyoko Asano, Takao Itoi
Format: Article
Language:English
Published: Wiley 2024-04-01
Series:DEN Open
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Online Access:https://doi.org/10.1002/deo2.308
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author Noriyuki Hirakawa
Kenjiro Yamamoto
Atsushi Sofuni
Takayoshi Tsuchiya
Kentaro Ishii
Reina Tanaka
Ryosuke Tonozuka
Shuntaro Mukai
Kazumasa Nagai
Yukitoshi Matsunami
Hiroyuki Kojima
Hirohito Minami
Ryosuke Nakatsubo
Kyoko Asano
Takao Itoi
author_facet Noriyuki Hirakawa
Kenjiro Yamamoto
Atsushi Sofuni
Takayoshi Tsuchiya
Kentaro Ishii
Reina Tanaka
Ryosuke Tonozuka
Shuntaro Mukai
Kazumasa Nagai
Yukitoshi Matsunami
Hiroyuki Kojima
Hirohito Minami
Ryosuke Nakatsubo
Kyoko Asano
Takao Itoi
author_sort Noriyuki Hirakawa
collection DOAJ
description Abstract Objectives Endoscopic transpapillary gallbladder drainage (ETGBD) is a highly technical procedure, but few studies have evaluated factors that predict its technical success. Therefore, in this study, we sought to identify predictors of technically successful ETGBD. Methods One hundred and eighty‐two patients who underwent ETGBD for acute cholecystitis at our hospital were retrospectively investigated. Factors associated with technical failure were identified by focusing on clinical characteristics, anatomical features (direction of the cystic duct branch and course of the cystic duct), and procedural factors (cystic duct and gallbladder with or without contrast and cystic duct injury). Results The technical success rate was 84.6% (154/182) and the clinical success rate was 96.1% (148/154). The adverse event rate was 11.0% (20/182; cystic duct injury in 13 patients, pancreatitis in six, and liver abscess in one. Univariate and multivariate analyses identified the right cranial direction and spiral‐type course of the cystic duct to be significant anatomical features and cystic duct injury to be a significant procedural feature contributing to the technical failure of ETGBD. Conclusions ETGBD is a highly practical procedure for patients with acute cholecystitis. However, difficulty is encountered in some cases because of anatomical and procedural factors. Our results suggest that ETGBD may be difficult and thus should not be performed in cases with the right cranial direction or spiral‐type course of the cystic duct or those with cystic duct injury.
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spelling doaj-art-b9ad6475a5da405b9fc7bf7f717584a22025-08-20T02:55:03ZengWileyDEN Open2692-46092024-04-0141n/an/a10.1002/deo2.308Factors predicting technical failure of endoscopic transpapillary gallbladder drainage for acute cholecystitisNoriyuki Hirakawa0Kenjiro Yamamoto1Atsushi Sofuni2Takayoshi Tsuchiya3Kentaro Ishii4Reina Tanaka5Ryosuke Tonozuka6Shuntaro Mukai7Kazumasa Nagai8Yukitoshi Matsunami9Hiroyuki Kojima10Hirohito Minami11Ryosuke Nakatsubo12Kyoko Asano13Takao Itoi14Department of Gastroenterology and Hepatology Tokyo Medical University Tokyo JapanDepartment of Gastroenterology and Hepatology Tokyo Medical University Tokyo JapanDepartment of Gastroenterology and Hepatology Tokyo Medical University Tokyo JapanDepartment of Gastroenterology and Hepatology Tokyo Medical University Tokyo JapanDepartment of Gastroenterology and Hepatology Tokyo Medical University Tokyo JapanDepartment of Gastroenterology and Hepatology Tokyo Medical University Tokyo JapanDepartment of Gastroenterology and Hepatology Tokyo Medical University Tokyo JapanDepartment of Gastroenterology and Hepatology Tokyo Medical University Tokyo JapanDepartment of Gastroenterology and Hepatology Tokyo Medical University Tokyo JapanDepartment of Gastroenterology and Hepatology Tokyo Medical University Tokyo JapanDepartment of Gastroenterology and Hepatology Tokyo Medical University Tokyo JapanDepartment of Gastroenterology and Hepatology Tokyo Medical University Tokyo JapanDepartment of Gastroenterology and Hepatology Tokyo Medical University Tokyo JapanDepartment of Gastroenterology and Hepatology Tokyo Medical University Tokyo JapanDepartment of Gastroenterology and Hepatology Tokyo Medical University Tokyo JapanAbstract Objectives Endoscopic transpapillary gallbladder drainage (ETGBD) is a highly technical procedure, but few studies have evaluated factors that predict its technical success. Therefore, in this study, we sought to identify predictors of technically successful ETGBD. Methods One hundred and eighty‐two patients who underwent ETGBD for acute cholecystitis at our hospital were retrospectively investigated. Factors associated with technical failure were identified by focusing on clinical characteristics, anatomical features (direction of the cystic duct branch and course of the cystic duct), and procedural factors (cystic duct and gallbladder with or without contrast and cystic duct injury). Results The technical success rate was 84.6% (154/182) and the clinical success rate was 96.1% (148/154). The adverse event rate was 11.0% (20/182; cystic duct injury in 13 patients, pancreatitis in six, and liver abscess in one. Univariate and multivariate analyses identified the right cranial direction and spiral‐type course of the cystic duct to be significant anatomical features and cystic duct injury to be a significant procedural feature contributing to the technical failure of ETGBD. Conclusions ETGBD is a highly practical procedure for patients with acute cholecystitis. However, difficulty is encountered in some cases because of anatomical and procedural factors. Our results suggest that ETGBD may be difficult and thus should not be performed in cases with the right cranial direction or spiral‐type course of the cystic duct or those with cystic duct injury.https://doi.org/10.1002/deo2.308cholecystitisendoscopic gallbladder stentingendoscopic nasogallbladder drainagegallbladdertranspapillary gallbladder drainage
spellingShingle Noriyuki Hirakawa
Kenjiro Yamamoto
Atsushi Sofuni
Takayoshi Tsuchiya
Kentaro Ishii
Reina Tanaka
Ryosuke Tonozuka
Shuntaro Mukai
Kazumasa Nagai
Yukitoshi Matsunami
Hiroyuki Kojima
Hirohito Minami
Ryosuke Nakatsubo
Kyoko Asano
Takao Itoi
Factors predicting technical failure of endoscopic transpapillary gallbladder drainage for acute cholecystitis
DEN Open
cholecystitis
endoscopic gallbladder stenting
endoscopic nasogallbladder drainage
gallbladder
transpapillary gallbladder drainage
title Factors predicting technical failure of endoscopic transpapillary gallbladder drainage for acute cholecystitis
title_full Factors predicting technical failure of endoscopic transpapillary gallbladder drainage for acute cholecystitis
title_fullStr Factors predicting technical failure of endoscopic transpapillary gallbladder drainage for acute cholecystitis
title_full_unstemmed Factors predicting technical failure of endoscopic transpapillary gallbladder drainage for acute cholecystitis
title_short Factors predicting technical failure of endoscopic transpapillary gallbladder drainage for acute cholecystitis
title_sort factors predicting technical failure of endoscopic transpapillary gallbladder drainage for acute cholecystitis
topic cholecystitis
endoscopic gallbladder stenting
endoscopic nasogallbladder drainage
gallbladder
transpapillary gallbladder drainage
url https://doi.org/10.1002/deo2.308
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