Risk factors for cholecystitis after metal stent placement in malignant biliary obstruction.
BACKGROUND
Cholecystitis related to metal stent placement is a morbid event.


OBJECTIVE
This study evaluated the risk factors of cholecystitis after metal stenting for malignant biliary obstruction.


METHODS
Between December 1997 and April 2003, 155 patients who were treated with a metal stent for malignant biliary obstruction were retrospectively enrolled.


METHODS
The incidence and characteristics of patients with cholecystitis were evaluated and compared with those of patients without cholecystitis. Patient characteristics and tumor or procedure-related data were recorded for the following variables: sex, age, tumor and stent length, stent type (covered vs uncovered), cholangitis before ERCP, degree of gallbladder filling with contrast medium during ERCP, primary disease type (Klatskin vs others), presence of gallbladder stones, and the relationship of the cystic duct orifice to the location of the tumor (across vs others).


RESULTS
There were 15 (9.7%) patients diagnosed with cholecystitis after metal stent insertion. The onset of cholecystitis was on average 4.6 days (range 1 to 26) after the procedure. We found that an obstruction across the cystic duct orifice by tumor (P < .01, odds ratio 12.7) and the presence of gallbladder stone (P = .01, odds ratio 6.6) were positively related to the cholecystitis after metal stent insertion.


CONCLUSIONS
The limitations of the study were the use of multiple types of stents and the retrospective design.


CONCLUSIONS
This study demonstrated that an obstruction across the cystic duct by tumor and the presence of gallbladder stone were risk factors for the development of cholecystitis after metal stent placement.
Suk
Ki Tae
KT
Divisions of Gastroenterology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
Kim
Hyun Soo
HS
Kim
Jae Woo
JW
Baik
Soon Koo
SK
Kwon
Sang Ok
SO
Kim
Ho Gak
HG
Lee
Don Haeng
DH
Yoo
Byung Moo
BM
Kim
Jin Hong
JH
Moon
Young Soo
YS
Lee
Dong Ki
DK
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002761:Cholangitis / Q000150:complications / Q000000981:diagnostic imaging; D002764:Cholecystitis / Q000209:etiology*; D001651:Cholestasis, Extrahepatic / Q000000981:diagnostic imaging / Q000628:therapy*; D003138:Common Bile Duct Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy*; D003549:Cystic Duct / Q000000981:diagnostic imaging / Q000473:pathology; D004867:Equipment Design; D005260:Female; D042882:Gallstones / Q000150:complications / Q000000981:diagnostic imaging; D006801:Humans; D018285:Klatskin Tumor / Q000000981:diagnostic imaging / Q000628:therapy; D008111:Liver Function Tests; D008297:Male; D008670:Metals / Q000009:adverse effects*; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects*
D008670:Metals