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Safety and efficacy of endoscopic ultrasound‐guided gallbladder drainage combined with endoscopic retrograde cholangiopancreatography in the same session
Author(s) -
Torres Yuste Raul,
GarciaAlonso Francisco Javier,
SanchezOcana Ramón,
Cimavilla Roman Marta,
Peñas Herrero Irene,
Carbajo Ana Yaiza,
De Benito Sanz Marina,
Mora Cuadrado Natalia,
De la Serna Higuera Carlos,
PerezMiranda Manuel
Publication year - 2020
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.13562
Subject(s) - medicine , endoscopic retrograde cholangiopancreatography , endoscopic ultrasound , randomized controlled trial , retrospective cohort study , gallbladder , stent , surgery , cholecystitis , adverse effect , endoscopic ultrasonography , common bile duct , endoscopy , pancreatitis
Background and Aim Endoscopic ultrasound‐guided gallbladder drainage (EUS‐GBD) is an emerging option for acute cholecystitis in non‐surgical candidates. Combining endoscopic retrograde cholangiopancreatography (ERCP) for common bile duct stones with EUS‐GBD in a single session might become a non‐surgical management strategy to comprehensively treat gallstone disease in selected patients. Methods Single‐center retrospective cohort study comparing outcomes between EUS‐GBD alone (group A) and single‐session ERCP combined with EUS‐GBD (group B). Consecutive patients who underwent EUS‐GBD with a lumen‐apposing metal stent (LAMS) between June 2011 and August 2018 were analyzed. Exclusion criteria were subjects included in randomized clinical trials, patients who had had ERCP within 5 days of EUS‐GBD, patients in whom ERCP or EUS‐GBD was carried out for salvage of one or the other procedure, and patients who underwent concurrent EUS‐guided biliary drainage. Results One hundred and nine consecutive patients underwent EUS‐GBD with LAMS during the study period. Seventy‐one patients satisfied the inclusion criteria and 34 patients were in group A and 37 in group B. Baseline characteristics were similar in both groups. There were no significant differences in technical (97.1% vs 97.3%; P = 0.19) and clinical success rates (88.2% vs 94.6%; P = 0.42) of EUS‐GBD in group A versus group B. Rate of adverse events was similar in both groups, five (14.7%) in group A versus five (13.5%) in group B. Conclusions Single‐session EUS‐GBD combined with ERCP has comparable rates of technical and clinical success to EUS‐GBD alone. A combined EUS‐GBD and ERCP procedure does not appear to increase adverse events and makes possible comprehensive treatment of gallstone disease by purely endoscopic means.