Cholecystitis after Placement of Covered Self-Expandable Metallic Stents in Patients with Distal Malignant Biliary Obstructions
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Background/Aims: Cholecystitis can occur after the placement of covered self-expandable metallic stents for distal malignant biliaryobstructions. We aimed to identify risk factors for cholecystitis following covered self-expandable metallic stent placement. Methods: We investigated risk factors related to cholecystitis following covered self-expandable metallic stent placement in 118patients with distal malignant biliary obstructions between January 1, 2015 and April 30, 2019. Endoscopic assessments and tumorinvasion to the arteries feeding the gallbladder were determined by a pancreaticobiliary endoscopist and a radiologist, respectively. Results: The median patient age was 72 years (men, 61.0%). The flow of the contrast agent into the gallbladder and tumorinvolvement in the orifice of the cystic duct were observed in 35 (29.7%) and 35 (29.7%) patients, respectively. During theobservation period (median, 179 days), cholecystitis occurred in 18 (15.3%) patients. Multivariate analysis revealed the flow ofthe contrast agent into the gallbladder (p=0.023) and tumor involvement in the orifice of the cystic duct (p=0.005) as significantindependent risk factors associated with cholecystitis. Conclusions: The flow of the contrast agent into the gallbladder and tumor involvement in the orifice of the cystic duct are potentialindependent risk factors for cholecystitis following the placement of covered self-expandable metallic stents. A follow-up prospectivestudy is warranted to validate their influence.
Abstract
Background/Aims: Cholecystitis can occur after the placement of covered self-expandable metallic stents for distal malignant biliaryobstructions. We aimed to identify risk factors for cholecystitis following covered self-expandable metallic stent placement. Methods: We investigated risk factors related to cholecystitis following covered self-expandable metallic stent placement in 118patients with distal malignant biliary obstructions between January 1, 2015 and April 30, 2019. Endoscopic assessments and tumorinvasion to the arteries feeding the gallbladder were determined by a pancreaticobiliary endoscopist and a radiologist, respectively. Results: The median patient age was 72 years (men, 61.0%). The flow of the contrast agent into the gallbladder and tumorinvolvement in the orifice of the cystic duct were observed in 35 (29.7%) and 35 (29.7%) patients, respectively. During theobservation period (median, 179 days), cholecystitis occurred in 18 (15.3%) patients. Multivariate analysis revealed the flow ofthe contrast agent into the gallbladder (p=0.023) and tumor involvement in the orifice of the cystic duct (p=0.005) as significantindependent risk factors associated with cholecystitis. Conclusions: The flow of the contrast agent into the gallbladder and tumor involvement in the orifice of the cystic duct are potentialindependent risk factors for cholecystitis following the placement of covered self-expandable metallic stents. A follow-up prospectivestudy is warranted to validate their influence.
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