title: Endoscopic nasogallbladder tube or stent placement in acute cholecystitis: a preliminary prospective randomized trial in Japan (with videos).
abstract: BACKGROUND
  There are currently no prospective, controlled trials of endoscopic transpapillary gallbladder drainage in patients with acute cholecystitis.
  
  
  OBJECTIVE
  We evaluated the technical success rate and efficacy of endoscopic transpapillary gallbladder drainage by using either endoscopic nasogallbladder drainage (ENGBD) or endoscopic gallbladder stenting (EGBS) for patients with acute cholecystitis.
  
  
  METHODS
  Randomized, controlled study.
  
  
  METHODS
  Tertiary-care referral centers.
  
  
  METHODS
  Seventy-three consecutive patients with acute cholecystitis were randomized.
  
  
  METHODS
  ENGBD by using a 5F or 7F tube (n = 37) or EGBS (n = 36) by using a 7F stent.
  
  
  METHODS
  Technical success, clinical success, adverse events, and procedure-related pain score.
  
  
  RESULTS
  The overall technical success rates in the ENGBD and EGBS groups were 91.9% and 86.1%, respectively (P > .05). The mean procedure times of ENGBD and EGBS were 20.3 ± 12.1 and 22.2 ± 14.5 minutes, respectively (P > .05). The overall clinical success rates by per protocol analysis were 94.1% and 90.3% in the ENGBD and EGBS groups, respectively, whereas the rates by intention-to-treat analysis were 86.5% and 77.8%, respectively (P > .05). Moderate adverse events were observed in the ENGBD (n = 2) and EGBS (n = 1) groups. The mean visual analog score of postprocedure pain in the ENGBD group was significantly higher than that in the EGBS group (1.3 ± 1.1 vs 0.4 ± 0.8, respectively; P < .001).
  
  
  CONCLUSIONS
  Small sample size and the participation of multiple endoscopists who may have different levels of experience in endoscopic transpapillary gallbladder drainage.
  
  
  CONCLUSIONS
  Both ENGBD and EGBS appear to be suitable for the treatment of acute cholecystitis in patients who are poor candidates for emergency cholecystectomy. (
  
  
  BACKGROUND
  UMIN000012316.).
authors.affiliation: Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Itoi
authors.affiliation: Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kawakami
authors.affiliation: Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Katanuma
authors.affiliation: Department of Gastroenterology, Aizu Medical Center, Fukushima Prefectural Medical College, Fukushima, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Irisawa
authors.affiliation: Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sofuni
authors.affiliation: Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Fumihide
authors.initials: F
authors.lastname: Itokawa
authors.affiliation: Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Tsuchiya
authors.affiliation: Department of Gastroenterology, Toda Chuo General Hospital, Saitama, Japan.
authors.forename: Reina
authors.initials: R
authors.lastname: Tanaka
authors.affiliation: Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Umeda
authors.affiliation: Department of Gastroenterology, Saitama Medical University International Medical Center, Saitama, Japan.
authors.forename: Shomei
authors.initials: S
authors.lastname: Ryozawa
authors.affiliation: Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Shinpei
authors.initials: S
authors.lastname: Doi
authors.affiliation: Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Naoya
authors.initials: N
authors.lastname: Sakamoto
authors.affiliation: Department of Gastroenterology, Teikyo University Mizonokuchi Hospital, Kawasaki, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Yasuda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D041881:Cholecystitis, Acute / Q000601:surgery*; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000379:methods*; D007564:Japan; D008297:Male; D008875:Middle Aged; D015607:Stents; D016896:Treatment Outcome