Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastrointest Endosc. Sep 16, 2026; 18(9): 125352
Published online Sep 16, 2026. doi: 10.4253/wjge.125352
Published online Sep 16, 2026. doi: 10.4253/wjge.125352
Long-term lumen-apposing metal stents in endoscopic ultrasound-guided gallbladder drainage: Late adverse events and stent removal
Koji Takahashi, Noa Minami, Kohei Horie, Taiga Sudo, Nana Yamada, Terunao Iwanaga, Takafumi Sakuma, Hidehiro Kamezaki, Department of Gastroenterology, Eastern Chiba Medical Center, Togane 283-8686, Chiba, Japan
Author contributions: Takahashi K conceived and designed the review and wrote the manuscript; Minami N, Horie K, and Sudo T performed the literature search and screened and selected the relevant studies; Yamada N and Iwanaga T assessed study eligibility, extracted the evidence and interpreted the findings; Sakuma T analyzed the extracted evidence and prepared the tables and figures; Kamezaki H supervised the review and critically revised the manuscript for important intellectual content; and all authors contributed to drafting or critically revising the manuscript, and have read and approved the final version.
AI contribution statement: No artificial intelligence tools were used during the preparation of this manuscript.
Supported by the Godo Shigen Grant for Academic Activities.
Conflict-of-interest statement: All authors declare that they have no conflicting interests related to this work.
Corresponding author: Koji Takahashi, MD, Department of Gastroenterology, Eastern Chiba Medical Center, 3-6-2, Okayamadai, Togane 283-8686, Chiba, Japan.
Received: July 8, 2026
Revised: August 17, 2026
Accepted: September 4, 2026
Published online: September 16, 2026
Processing time: 64 Days and 16.8 Hours
Revised: August 17, 2026
Accepted: September 4, 2026
Published online: September 16, 2026
Processing time: 64 Days and 16.8 Hours
Core Tip
Core Tip: Lumen-apposing metal stents were designed for short-term drainage, yet after endoscopic ultrasound-guided gallbladder drainage, many remain in place for years. We reframe the choice to remove, exchange, or retain as a competing risks decision. Removal prevents late stent-specific events but risks recurrent cholecystitis, whereas the apparent safety of permanent stents partly reflects the truncated follow-up of a high-mortality population. We argue for deciding the fate of the stent at the index procedure based on the clinical trajectory of the patient, reserving permanent placement for those who will never become surgical candidates, and we outline the prospective studies needed.