Case Report
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World J Gastrointest Endosc. Feb 16, 2011; 3(2): 46-48
Published online Feb 16, 2011. doi: 10.4253/wjge.v3.i2.46
Endoscopic transpapillary gallbladder drainage with replacement of a covered self-expandable metal stent
Kazumichi Kawakubo, Hiroyuki Isayama, Naoki Sasahira, Yousuke Nakai, Hirofumi Kogure, Takashi Sasaki, Kenji Hirano, Minoru Tada, Kazuhiko Koike
Kazumichi Kawakubo, Hiroyuki Isayama, Naoki Sasahira, Yousuke Nakai, Hirofumi Kogure, Takashi Sasaki, Kenji Hirano, Minoru Tada, Kazuhiko Koike, Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
Author contributions: Kawakubo K, Isayama H, Sasahira N, Kogure H and Nakai Y designed the research; Sasaki T, Hirano K and Tada M criticized the paper for important intellectual content; Koike K finally approved the paper; Kawakubo K wrote the article.
Correspondence to: Hiroyuki Isayama, MD, Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. isayama-2im@h.u-tokyo.ac.jp
Telephone: +81-3-38155411 Fax: +81-3-38140021
Received: September 1, 2010
Revised: October 26, 2010
Accepted: November 2, 2010
Published online: February 16, 2011
Abstract

Endoscopic self-expandable metal stent (SEMS) placement has become a standard palliative therapy for patients with malignant biliary obstruction. Acute cholecystitis after SEMS placement is a serious complication. We report a patient with an acute cholecystitis after covered SEMS placement, who was managed successfully with endoscopic transpapillary gallbladder drainage (ETGBD) and replacement of the covered SEMS. An 85-year-old man with pancreatic cancer suffered from acute cholecystitis after covered SEMS placement. It was impossible to perform percutaneous transhepatic gallbladder drainage. After removal of the covered SEMS with a snare, a 7Fr double pigtail stent was placed between the gallbladder and duodenum, subsequently followed by another covered SEMS insertion into the common bile duct beside the gallbladder stent. The cholecystitis improved immediately after ETGBD. ETGBD with replacement of the covered SEMS thus proved to be effective for treatment of patients with acute cholecystitis after covered SEMS placement.

Keywords: Self-expandable metal stent; Cholecystitis; Endoscopic transpapillary gallbladder drainage