P0016 - Endoscopic Gallbladder Drainage via Trans-Papillary Gallbladder Stent Placement Is Safe, Feasible and Effective in a Non-Tertiary Care Center: Outcomes From an Academic Community Hospital Setting

Vijay S. Are, MD¹, Natalie Wilson, MD¹, Nicholas McDonald, MD², Anders Westanmo, PharmD³, Dharma Sunjaya, MD¹, Susan Lou, MD⁴, Brian J. Hanson, MD³, Mohammad Bilal, MD^5
1University of Minnesota, Minneapolis, MN; ²University of Minnesota, MInneapolis, MN; ³Minneapolis VA Medical Center, Minneapolis, MN; ⁴University of Minnesota Medical Center, Minneapolis, MN; ⁵University of Minnesota and Minneapolis Veterans Affairs Health Care System, Minneapolis, MN

Introduction: Surgical cholecystectomy is the gold standard for treatment of cholecystitis. However, in patients who are not surgical candidates, endoscopic gallbladder drainage using endoscopic retrograde cholangiopancreatography (ERCP) guided trans-papillary stent placement (EGTPS) can be performed to manage cholecystitis. While this technique has been well established for the last two decades, published experience within the United States has been limited to tertiary and quaternary care centers. The feasibility, efficacy and safety of EGTPS in a non-tertiary care center is unknown. We aimed to evaluate the outcomes of EGTPS in patients with cholecystitis in an academic community hospital.

Methods: This was a retrospective single center study of consecutive patients with acalculous and calculous acute cholecystitis or chronic cholecystitis who underwent attempted EGTPS from December 2010 to October 2022. Patient demographics, laboratory data and procedural characteristics were recorded. Primary outcomes were technical and clinical success. Technical success was defined as the ability to place at least one stent into the gallbladder. Clinical success was defined as improvement or resolution of gallbladder related symptoms within 5 days of procedure. Other outcomes included long-term success, adverse events and procedure related mortality. Long-term success was defined as no recurrent cholecystitis for 6 months or until elective cholecystectomy was performed.

Results: A total of 50 patients underwent attempted EGTPS. 96% were male and mean age was 71 years (± 18.4). Baseline characteristics are summarized in the Table. Technical success was achieved in 84% of cases, and clinical success was achieved in 86% of cases where technical success was achieved. The mean follow-up duration was 713 days. 3 patients had post-ERCP pancreatitis while 2 patients had minor post sphincterotomy bleeding. Long-term success was achieved in 97% of the patients who had clinical success. No procedure related mortality was seen.

Discussion: ERCP guided trans-papillary stent placement is a safe and effective modality for patients with cholecystitis who are non-surgical candidates or cannot undergo immediate cholecystectomy. The feasibility and outcomes of EGTPS performed in an academic community hospital are comparable to reports from tertiary and quaternary care centers.


Disclosures:


Vijay S. Are, MD¹, Natalie Wilson, MD¹, Nicholas McDonald, MD², Anders Westanmo, PharmD³, Dharma Sunjaya, MD¹, Susan Lou, MD⁴, Brian J. Hanson, MD³, Mohammad Bilal, MD⁵. P0016 - Endoscopic Gallbladder Drainage via Trans-Papillary Gallbladder Stent Placement Is Safe, Feasible and Effective in a Non-Tertiary Care Center: Outcomes From an Academic Community Hospital Setting, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.