Inflauence of elective endoscopic transpapillary gallbladder drainage on the management of acute cholecystitis: A retrospective study

Background Endoscopic transpapillary gallbladder drainage (ETGBD) is used for managing acute cholecystitis (AC) in patients contraindicated for surgery; however, ETGBD is considered challenging, has comparatively lower success rates, and is associated with severe adverse events (AEs). Only a few studies have examined the procedural and anatomical factors affecting technical ETGBD success. This study identified predictive factors for ETGBD in AC to improve success rates and minimize AEs. Methods This study assessed patients treated with ETGBD for AC. Factors associated with technical failure were analyzed based on interval from symptom onset to ETGBD, presence of cystic duct stones, and cystic duct diameter. Results Among 68 patients, the technical success and AE rates were 64.7% and 19.1%, respectively (cystic duct perforation, 8.8%; pancreatitis, 5.9%). Multivariate analysis revealed that early ETGBD and stone impaction in the cystic duct were significant factors associated with technical ETGBD failure. Subgroup analysis demonstrated that early ETGBD was associated with a significantly higher risk of cystic duct perforation and a lower success rate than delayed intervention. Thus, elective ETGBD may enhance procedural success, reducing the risk of cystic duct perforation. Conclusion Elective ETGBD may be considered in cases where ETGBD is anticipated to be challenging.