Rolston, Vineet S.
https://orcid.org/0000-0001-7975-8508
Mayo Clinic
Memorial Sloan Kettering Cancer Center
Citations 1
US multicenter outcomes of endoscopic ultrasound-guided gallbladder drainage with lumen-apposing metal stents for acute cholecystitis
David, Yakira , Kakked, Gaurav, Confer, Bradley , Shah, Ruchit N. , Khara, Harshit S. , Diehl, David L. , Krafft, Matthew , Shah-Khan, Sardar M. , Nasr, John , Benias, Petros C. , Muniraj, Thiruvengadam , Aslanian, Harry R., Chahal, Prabhleen , Rodriguez, John , DuBroff, Jason, Latour, Rabi De, Khanna, Lauren , Haber, Gregory , Hoerter, Nicholas A. , Pandey, Nishi , Bakhit, Mena , Kowalski, Thomas E., Loren, David E. , Chiang, Austin , Schlachterman, Alexander , Nieto, Jose , Ichkhanian, Yervant , Khashab, Mouen A. , Halabi, Maan El , Kwon, Richard S. , Hernandez-Lara, Ariosto, Poneros, John M., Sethi, Amrita, Gonda, Tamas A. , Kushnir, Vladimir , Cosgrove, Natalie , Mullady, Daniel , Al-Shahrani, Abdullah , Buscaglia, Jonathan M. , Bucobo, Juan Carlos , Rolston, Vineet S. , Kedia, Prashant , Kasmin, Franklin, Kumta, Nikhil A. , DiMaio, Christopher J. , Krafft, Matthew Richard , Trindade, Arvind J. , Adler, Douglas G. , Tzimas, Demetrios J. , Goodman, Adam J. , Nieto, José , Deshmukh, Ameya A. , Prabhu, Anoop , Storm, Andrew C. , Berzin, Tyler M. , Sethi, Amrita , D'Souza, Lionel S. , Nagula, Satish
Endoscopy International Open | January 13, 2025 | Volume: 13 | Issue: CP | Pages: No page available
AbstractEUS-guided gallbladder drainage (EUS-GBD) using lumen apposing metal stents (LAMS) has excellent technical and short-term clinical success for acute cholecystitis (AC). The goals of this study were to determine the long-term clinical outcomes and adverse events (AEs) of EUS-GBD with LAMS.A multicenter, retrospective study was conducted at 18 US tertiary care institutions. Inclusion criteria: any AC patient with attempted EUS-GBD with LAMS and minimum 30-day post-procedure follow-up. Long-term clinical success was defined as absence of recurrent acute cholecystitis (RAC) > 30 days and long-term AE was defined as occurring > 30 days from the index procedure.A total of 109 patients were included. Technical success was achieved in 108 of 109 (99.1%) and initial clinical success in 106 of 109 (97.2%). Long-term clinical success was achieved in 98 of 109 (89.9%) over a median follow-up of 140 days (range 30–1188). On multivariable analysis (MVA), acalculous cholecystitis (odds ratio [OR] 15.93, 95% confidence interval [CI] 1.22–208.52, P = 0.04) and the occurrence of a LAMS-specific AE (OR 63.60, 95% CI 5.08–799.29, P <0.01) were associated with RAC. AEs occurred in 38 of 109 patients (34.9%) at any time, and in 10 of 109 (9.17%) > 30 days from the index procedure. Most long-term AEs (7 of 109; 6.42%) were LAMS-specific. No technical or clinical factors were associated with occurrence of AEs. LAMS were removed in 24 of 109 patients (22%). There was no difference in RAC or AEs whether LAMS was removed or not.EUS-GBD with LAMS has a high rate of long-term clinical success and modest AE rates in patients with AC and is a reasonable destination therapy for high-risk surgical candidates.