Gut Liver.  2015 Mar;9(2):239-246. 10.5009/gnl14070.

Feasibility, Efficacy, and Predictive Factors for the Technical Success of Endoscopic Nasogallbladder Drainage: A Prospective Study

• Yane K
• Maguchi H
• Katanuma A
• Takahashi
• Osanai M
• Kin T
• Takaki R
• Matsumoto
• Gon K
• Matsumori
• Tomonari A
• Nojima M

• KMID: 2380770
• DOI: http://doi.org/10.5009/gnl14070

Abstract

BACKGROUND/AIMS
Several studies have shown the usefulness of endoscopic nasogallbladder drainage (ENGBD) in patients with acute cholecystitis. However, the procedure is difficult, and factors that affect technical success have not yet been clarified. We conducted a prospective study to evaluate the technical feasibility, efficacy, and predictive factors for the technical success of ENGBD in patients with acute cholecystitis.
METHODS
All patients with moderate or severe acute cholecystitis who were enrolled underwent ENGBD between April 2009 and April 2011. Patients with surgically altered anatomy or pancreatobiliary malignancies were excluded. The primary outcomes included technical success, clinical success, and complications. Factors that could affect the technical success were also examined.
RESULTS
Of the 27 patients who underwent ENGBD during the study period, technical success was achieved in 21 (78%) and clinical improvement was achieved in 20 (95%). Early complications were encountered in four patients (15%). Gallbladder wall thickness (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.08 to 2.47) and age (OR, 1.16; 95% CI, 1.00 to 1.35) were effective predictors of technical failure.
CONCLUSIONS
ENGBD was effective in resolving acute cholecystitis; however, this modality was technically challenging and had a limited success rate. Because of technical difficulties, ENGBD should be reserved for limited indications.

Keyword

Acute cholecystitis; Endoscopic retrograde cholangiopancreatography; Gallbladder drainage

MeSH Terms

Age Factors
Aged
Aged, 80 and over
Cholecystitis, Acute/*surgery
Drainage/*methods
Endoscopy, Gastrointestinal/*methods
Feasibility Studies
Female
Gallbladder/pathology/*surgery
Humans
Male
Middle Aged
Odds Ratio
Postoperative Complications/epidemiology
Prospective Studies
Sphincterotomy, Endoscopic
Treatment Outcome