title: Endoscopic transpapillary gallbladder drainage with replacement of a covered self-expandable metal stent.
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.
authors.affiliation: 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.
authors.forename: Kazumichi
authors.initials: K
authors.lastname: Kawakubo
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Isayama
authors.forename: Naoki
authors.initials: N
authors.lastname: Sasahira
authors.forename: Yousuke
authors.initials: Y
authors.lastname: Nakai
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Kogure
authors.forename: Takashi
authors.initials: T
authors.lastname: Sasaki
authors.forename: Kenji
authors.initials: K
authors.lastname: Hirano
authors.forename: Minoru
authors.initials: M
authors.lastname: Tada
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Koike