Three-way comparative study of endoscopic ultrasound-guided transmural gallbladder drainage using lumen-apposing metal stents versus endoscopic transpapillary drainage versus percutaneous cholecystostomy for gallbladder drainage in high-risk surgical patients with acute cholecystitis: clinical outcomes and success in an International, Multicenter Study

Ali Siddiqui; Rastislav Kunda; Amy Tyberg; Mustafa A. Arain; Arish Noor; Tayebah Mumtaz; Usama Iqbal; David E. Loren; Thomas E. Kowalski; Douglas G. Adler; Monica Saumoy; Monica Gaidhane; Shawn Mallery; Eric M. Christiansen; Jose Nieto; Michel Kahaleh

doi:10.1007/s00464-018-6406-7

Three-way comparative study of endoscopic ultrasound-guided transmural gallbladder drainage using lumen-apposing metal stents versus endoscopic transpapillary drainage versus percutaneous cholecystostomy for gallbladder drainage in high-risk surgical patients with acute cholecystitis: clinical outcomes and success in an International, Multicenter Study

Ali Siddiqui, Rastislav Kunda, Amy Tyberg, Mustafa A. Arain, Arish Noor, Tayebah Mumtaz, Usama Iqbal, David E. Loren, Thomas E. Kowalski, Douglas G. Adler, Monica Saumoy, Monica Gaidhane, Shawn Mallery, Eric M. Christiansen, Jose Nieto, Michel Kahaleh

Medicine - Gastro, Hepatology, Nutrition Division

Research output: Contribution to journal › Article › peer-review

85 Scopus citations

Abstract

Background: Percutaneous cholecystostomy tube (PTGBD), endoscopic retrograde cholangiopancreatography with transpapillary gallbladder drainage (TP), and endoscopic ultrasound-guided transmural gallbladder drainage (EGBD) using lumen-apposing metal stents (LAMS) have been offered for gallbladder decompression for acute cholecystitis in high-risk surgical patients. Yet, there are limited data comparing these therapies. Our aim was to compare the safety and efficacy of EGBD to TP and PTGBD for gallbladder drainage. Methods: We retrospectively collected high-risk surgical patients from six centers with acute cholecystitis who underwent gallbladder drainage by EGBD, TP, or PTGBD. Data included technical success (gallbladder drainage), clinical success (acute cholecystitis resolution), adverse events (AE), and follow-up. Results: From 2010 to 2016, 372 patients underwent gallbladder drainage, with 146 by PTGBD, 124 by TP, and 102 drained by EGBD. Technical (98% vs. 88% vs. 94%; p = 0.004) and Clinical (97% vs. 90% vs. 80%; p < 0.001) success rates were significantly higher with PTGBD and EGBD compared to TP. PTGBD group had statistically significantly higher number of complications as compared to EGBD and TP groups (2 0% vs. 2% vs. 5%; p = 0.01). Mean hospital stay in the EGBD group was significantly less than TP and PTGBD (16 vs. 18 vs. 19 days; p = 0.01), while additional surgical intervention was significantly higher in the PTGBD group compared to the EGBD and TP groups (49% vs. 4% vs. 11%; p < 0.0001). Conclusions: EGBD with LAMS is an effective and safer alternative to TP and PTGBD for treatment of patients with acute cholecystitis who cannot undergo surgery. EGBD with LAMS has significantly lower overall AEs, hospital stay, and unplanned admissions compared to PTGBD. Trial registration: ClinicalTrials.gov Identifier: NCT01522573.

Original language	English (US)
Pages (from-to)	1260-1270
Number of pages	11
Journal	Surgical endoscopy
Volume	33
Issue number	4
DOIs	https://doi.org/10.1007/s00464-018-6406-7
State	Published - Apr 15 2019

Bibliographical note

Funding Information:
Disclosures Michel Kahaleh, MD has received grant support from Boston Scientific, Fujinon, EMcision, Xlumena Inc., W.L. Gore, MaunaKea, Apollo Endosurgery, Cook Endoscopy, ASPIRE Bariatrics, GI Dynamics, NinePoint Medical, Merit Medical, Olympus, and MI Tech. He is a consultant for Boston Scientific, Xlumena Inc., Concordia Laboratories Inc, AbbVie, and MaunaKea Tech. Ali Sid-diqui, MD is a consultant for Boston Scientific, Cook Endoscopy, and Medtronic. He has received research grant support from Boston Scientific and Medtronic. He is a speaker for AbbVie. Jose Nieto, MD is a consultant for Boston Scientific. Shawn Mallery, MD is a consultant for Boston Scientific. Douglas Adler, MD is a consultant for Boston Scientific. Thomas Kowalski, MD is a consultant for Boston Scientific and Medtronic. David Loren, MD is a consultant for Boston Scientific and has received grant support from Medtronic. Rastislav Kunda, MD is a consultant for Boston Scientific, BCM Korea, Olympus Japan, and Omega Medical Imaging. Eric Chrisiansen MD, Monica Gaid-hane MD, Amy Tyberg MD, Usama Iqbal MD, Tayebah Mumtaz MD, Arish Noor MD, Mustafa Arain MD, and Monica Saumoy MD, have no conflicts of interest or financial ties to disclose.

Publisher Copyright:
© 2018, Springer Science+Business Media, LLC, part of Springer Nature.

Keywords

Cholecystitis
Cholecystostomy
EGBD
ERCP
Endoscopic retrograde cholangiopancreatography
Endoscopic ultrasound-guided transmural gallbladder drainage
Gallbladder drainage
LAMS
PTGBD
Transpapillary gallbladder drainage

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Siddiqui, A., Kunda, R., Tyberg, A., Arain, M. A., Noor, A., Mumtaz, T., Iqbal, U., Loren, D. E., Kowalski, T. E., Adler, D. G., Saumoy, M., Gaidhane, M., Mallery, S., Christiansen, E. M., Nieto, J., & Kahaleh, M. (2019). Three-way comparative study of endoscopic ultrasound-guided transmural gallbladder drainage using lumen-apposing metal stents versus endoscopic transpapillary drainage versus percutaneous cholecystostomy for gallbladder drainage in high-risk surgical patients with acute cholecystitis: clinical outcomes and success in an International, Multicenter Study. Surgical endoscopy, 33(4), 1260-1270. https://doi.org/10.1007/s00464-018-6406-7

Three-way comparative study of endoscopic ultrasound-guided transmural gallbladder drainage using lumen-apposing metal stents versus endoscopic transpapillary drainage versus percutaneous cholecystostomy for gallbladder drainage in high-risk surgical patients with acute cholecystitis: clinical outcomes and success in an International, Multicenter Study. / Siddiqui, Ali; Kunda, Rastislav; Tyberg, Amy et al.
In: Surgical endoscopy, Vol. 33, No. 4, 15.04.2019, p. 1260-1270.

Research output: Contribution to journal › Article › peer-review

Siddiqui, A, Kunda, R, Tyberg, A, Arain, MA, Noor, A, Mumtaz, T, Iqbal, U, Loren, DE, Kowalski, TE, Adler, DG, Saumoy, M, Gaidhane, M, Mallery, S, Christiansen, EM, Nieto, J & Kahaleh, M 2019, 'Three-way comparative study of endoscopic ultrasound-guided transmural gallbladder drainage using lumen-apposing metal stents versus endoscopic transpapillary drainage versus percutaneous cholecystostomy for gallbladder drainage in high-risk surgical patients with acute cholecystitis: clinical outcomes and success in an International, Multicenter Study', Surgical endoscopy, vol. 33, no. 4, pp. 1260-1270. https://doi.org/10.1007/s00464-018-6406-7

Siddiqui A, Kunda R, Tyberg A, Arain MA, Noor A, Mumtaz T et al. Three-way comparative study of endoscopic ultrasound-guided transmural gallbladder drainage using lumen-apposing metal stents versus endoscopic transpapillary drainage versus percutaneous cholecystostomy for gallbladder drainage in high-risk surgical patients with acute cholecystitis: clinical outcomes and success in an International, Multicenter Study. Surgical endoscopy. 2019 Apr 15;33(4):1260-1270. doi: 10.1007/s00464-018-6406-7

Siddiqui, Ali ; Kunda, Rastislav ; Tyberg, Amy et al. / Three-way comparative study of endoscopic ultrasound-guided transmural gallbladder drainage using lumen-apposing metal stents versus endoscopic transpapillary drainage versus percutaneous cholecystostomy for gallbladder drainage in high-risk surgical patients with acute cholecystitis : clinical outcomes and success in an International, Multicenter Study. In: Surgical endoscopy. 2019 ; Vol. 33, No. 4. pp. 1260-1270.

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title = "Three-way comparative study of endoscopic ultrasound-guided transmural gallbladder drainage using lumen-apposing metal stents versus endoscopic transpapillary drainage versus percutaneous cholecystostomy for gallbladder drainage in high-risk surgical patients with acute cholecystitis: clinical outcomes and success in an International, Multicenter Study",

abstract = "Background: Percutaneous cholecystostomy tube (PTGBD), endoscopic retrograde cholangiopancreatography with transpapillary gallbladder drainage (TP), and endoscopic ultrasound-guided transmural gallbladder drainage (EGBD) using lumen-apposing metal stents (LAMS) have been offered for gallbladder decompression for acute cholecystitis in high-risk surgical patients. Yet, there are limited data comparing these therapies. Our aim was to compare the safety and efficacy of EGBD to TP and PTGBD for gallbladder drainage. Methods: We retrospectively collected high-risk surgical patients from six centers with acute cholecystitis who underwent gallbladder drainage by EGBD, TP, or PTGBD. Data included technical success (gallbladder drainage), clinical success (acute cholecystitis resolution), adverse events (AE), and follow-up. Results: From 2010 to 2016, 372 patients underwent gallbladder drainage, with 146 by PTGBD, 124 by TP, and 102 drained by EGBD. Technical (98% vs. 88% vs. 94%; p = 0.004) and Clinical (97% vs. 90% vs. 80%; p < 0.001) success rates were significantly higher with PTGBD and EGBD compared to TP. PTGBD group had statistically significantly higher number of complications as compared to EGBD and TP groups (2 0% vs. 2% vs. 5%; p = 0.01). Mean hospital stay in the EGBD group was significantly less than TP and PTGBD (16 vs. 18 vs. 19 days; p = 0.01), while additional surgical intervention was significantly higher in the PTGBD group compared to the EGBD and TP groups (49% vs. 4% vs. 11%; p < 0.0001). Conclusions: EGBD with LAMS is an effective and safer alternative to TP and PTGBD for treatment of patients with acute cholecystitis who cannot undergo surgery. EGBD with LAMS has significantly lower overall AEs, hospital stay, and unplanned admissions compared to PTGBD. Trial registration: ClinicalTrials.gov Identifier: NCT01522573.",

keywords = "Cholecystitis, Cholecystostomy, EGBD, ERCP, Endoscopic retrograde cholangiopancreatography, Endoscopic ultrasound-guided transmural gallbladder drainage, Gallbladder drainage, LAMS, PTGBD, Transpapillary gallbladder drainage",

author = "Ali Siddiqui and Rastislav Kunda and Amy Tyberg and Arain, {Mustafa A.} and Arish Noor and Tayebah Mumtaz and Usama Iqbal and Loren, {David E.} and Kowalski, {Thomas E.} and Adler, {Douglas G.} and Monica Saumoy and Monica Gaidhane and Shawn Mallery and Christiansen, {Eric M.} and Jose Nieto and Michel Kahaleh",

note = "Funding Information: Disclosures Michel Kahaleh, MD has received grant support from Boston Scientific, Fujinon, EMcision, Xlumena Inc., W.L. Gore, MaunaKea, Apollo Endosurgery, Cook Endoscopy, ASPIRE Bariatrics, GI Dynamics, NinePoint Medical, Merit Medical, Olympus, and MI Tech. He is a consultant for Boston Scientific, Xlumena Inc., Concordia Laboratories Inc, AbbVie, and MaunaKea Tech. Ali Sid-diqui, MD is a consultant for Boston Scientific, Cook Endoscopy, and Medtronic. He has received research grant support from Boston Scientific and Medtronic. He is a speaker for AbbVie. Jose Nieto, MD is a consultant for Boston Scientific. Shawn Mallery, MD is a consultant for Boston Scientific. Douglas Adler, MD is a consultant for Boston Scientific. Thomas Kowalski, MD is a consultant for Boston Scientific and Medtronic. David Loren, MD is a consultant for Boston Scientific and has received grant support from Medtronic. Rastislav Kunda, MD is a consultant for Boston Scientific, BCM Korea, Olympus Japan, and Omega Medical Imaging. Eric Chrisiansen MD, Monica Gaid-hane MD, Amy Tyberg MD, Usama Iqbal MD, Tayebah Mumtaz MD, Arish Noor MD, Mustafa Arain MD, and Monica Saumoy MD, have no conflicts of interest or financial ties to disclose. Publisher Copyright: {\textcopyright} 2018, Springer Science+Business Media, LLC, part of Springer Nature.",

year = "2019",

month = apr,

day = "15",

doi = "10.1007/s00464-018-6406-7",

language = "English (US)",

volume = "33",

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TY - JOUR

T1 - Three-way comparative study of endoscopic ultrasound-guided transmural gallbladder drainage using lumen-apposing metal stents versus endoscopic transpapillary drainage versus percutaneous cholecystostomy for gallbladder drainage in high-risk surgical patients with acute cholecystitis

T2 - clinical outcomes and success in an International, Multicenter Study

AU - Siddiqui, Ali

AU - Kunda, Rastislav

AU - Tyberg, Amy

AU - Arain, Mustafa A.

AU - Noor, Arish

AU - Mumtaz, Tayebah

AU - Iqbal, Usama

AU - Loren, David E.

AU - Kowalski, Thomas E.

AU - Adler, Douglas G.

AU - Saumoy, Monica

AU - Gaidhane, Monica

AU - Mallery, Shawn

AU - Christiansen, Eric M.

AU - Nieto, Jose

AU - Kahaleh, Michel

N1 - Funding Information: Disclosures Michel Kahaleh, MD has received grant support from Boston Scientific, Fujinon, EMcision, Xlumena Inc., W.L. Gore, MaunaKea, Apollo Endosurgery, Cook Endoscopy, ASPIRE Bariatrics, GI Dynamics, NinePoint Medical, Merit Medical, Olympus, and MI Tech. He is a consultant for Boston Scientific, Xlumena Inc., Concordia Laboratories Inc, AbbVie, and MaunaKea Tech. Ali Sid-diqui, MD is a consultant for Boston Scientific, Cook Endoscopy, and Medtronic. He has received research grant support from Boston Scientific and Medtronic. He is a speaker for AbbVie. Jose Nieto, MD is a consultant for Boston Scientific. Shawn Mallery, MD is a consultant for Boston Scientific. Douglas Adler, MD is a consultant for Boston Scientific. Thomas Kowalski, MD is a consultant for Boston Scientific and Medtronic. David Loren, MD is a consultant for Boston Scientific and has received grant support from Medtronic. Rastislav Kunda, MD is a consultant for Boston Scientific, BCM Korea, Olympus Japan, and Omega Medical Imaging. Eric Chrisiansen MD, Monica Gaid-hane MD, Amy Tyberg MD, Usama Iqbal MD, Tayebah Mumtaz MD, Arish Noor MD, Mustafa Arain MD, and Monica Saumoy MD, have no conflicts of interest or financial ties to disclose. Publisher Copyright: © 2018, Springer Science+Business Media, LLC, part of Springer Nature.

PY - 2019/4/15

Y1 - 2019/4/15

N2 - Background: Percutaneous cholecystostomy tube (PTGBD), endoscopic retrograde cholangiopancreatography with transpapillary gallbladder drainage (TP), and endoscopic ultrasound-guided transmural gallbladder drainage (EGBD) using lumen-apposing metal stents (LAMS) have been offered for gallbladder decompression for acute cholecystitis in high-risk surgical patients. Yet, there are limited data comparing these therapies. Our aim was to compare the safety and efficacy of EGBD to TP and PTGBD for gallbladder drainage. Methods: We retrospectively collected high-risk surgical patients from six centers with acute cholecystitis who underwent gallbladder drainage by EGBD, TP, or PTGBD. Data included technical success (gallbladder drainage), clinical success (acute cholecystitis resolution), adverse events (AE), and follow-up. Results: From 2010 to 2016, 372 patients underwent gallbladder drainage, with 146 by PTGBD, 124 by TP, and 102 drained by EGBD. Technical (98% vs. 88% vs. 94%; p = 0.004) and Clinical (97% vs. 90% vs. 80%; p < 0.001) success rates were significantly higher with PTGBD and EGBD compared to TP. PTGBD group had statistically significantly higher number of complications as compared to EGBD and TP groups (2 0% vs. 2% vs. 5%; p = 0.01). Mean hospital stay in the EGBD group was significantly less than TP and PTGBD (16 vs. 18 vs. 19 days; p = 0.01), while additional surgical intervention was significantly higher in the PTGBD group compared to the EGBD and TP groups (49% vs. 4% vs. 11%; p < 0.0001). Conclusions: EGBD with LAMS is an effective and safer alternative to TP and PTGBD for treatment of patients with acute cholecystitis who cannot undergo surgery. EGBD with LAMS has significantly lower overall AEs, hospital stay, and unplanned admissions compared to PTGBD. Trial registration: ClinicalTrials.gov Identifier: NCT01522573.

AB - Background: Percutaneous cholecystostomy tube (PTGBD), endoscopic retrograde cholangiopancreatography with transpapillary gallbladder drainage (TP), and endoscopic ultrasound-guided transmural gallbladder drainage (EGBD) using lumen-apposing metal stents (LAMS) have been offered for gallbladder decompression for acute cholecystitis in high-risk surgical patients. Yet, there are limited data comparing these therapies. Our aim was to compare the safety and efficacy of EGBD to TP and PTGBD for gallbladder drainage. Methods: We retrospectively collected high-risk surgical patients from six centers with acute cholecystitis who underwent gallbladder drainage by EGBD, TP, or PTGBD. Data included technical success (gallbladder drainage), clinical success (acute cholecystitis resolution), adverse events (AE), and follow-up. Results: From 2010 to 2016, 372 patients underwent gallbladder drainage, with 146 by PTGBD, 124 by TP, and 102 drained by EGBD. Technical (98% vs. 88% vs. 94%; p = 0.004) and Clinical (97% vs. 90% vs. 80%; p < 0.001) success rates were significantly higher with PTGBD and EGBD compared to TP. PTGBD group had statistically significantly higher number of complications as compared to EGBD and TP groups (2 0% vs. 2% vs. 5%; p = 0.01). Mean hospital stay in the EGBD group was significantly less than TP and PTGBD (16 vs. 18 vs. 19 days; p = 0.01), while additional surgical intervention was significantly higher in the PTGBD group compared to the EGBD and TP groups (49% vs. 4% vs. 11%; p < 0.0001). Conclusions: EGBD with LAMS is an effective and safer alternative to TP and PTGBD for treatment of patients with acute cholecystitis who cannot undergo surgery. EGBD with LAMS has significantly lower overall AEs, hospital stay, and unplanned admissions compared to PTGBD. Trial registration: ClinicalTrials.gov Identifier: NCT01522573.

KW - Cholecystitis

KW - Cholecystostomy

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KW - ERCP

KW - Endoscopic retrograde cholangiopancreatography

KW - Endoscopic ultrasound-guided transmural gallbladder drainage

KW - Gallbladder drainage

KW - LAMS

KW - PTGBD

KW - Transpapillary gallbladder drainage

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