title: Feasibility of per-oral cholecystoscopy and advanced gallbladder interventions after EUS-guided gallbladder stenting (with video).
abstract: OBJECTIVE
  The recent development of EUS-guided gallbladder drainage (EGBD) with a lumen-apposing stent has made endoscopic assessment and advanced gallbladder interventions via the stent possible. The aim of this study was to assess the feasibility and safety of per-oral cholecystoscopy and the types of gallbladder interventions that can be performed.
  
  
  METHODS
  This was a retrospective review conducted in the Prince of Wales Hospital from June 2012 to March 2016. All patients who had acute cholecystitis with EGBD were included. Cholecystoscopy was performed 1 to 3 months after stent insertion. Patients' demographic data, technical success, types of intervention, and adverse events were recorded.
  
  
  RESULTS
  Twenty-nine cholecystoscopies were performed in 25 patients. Twenty-seven of 29 cholecystoscopies were successful (93.1%). Magnifying endoscopy was performed in 10 patients, confocal endomicroscopy and EUS in 1 patient, and endocytoscopy in another patient. Fourteen patients (56%) had spontaneous stone passage. Eleven patients (44%) had residual gallstones on cholecystoscopy, and removed in 8. Overall stone clearance rate was 88% after a mean (standard deviation) number of 1.25 (0.46) sessions of cholecystoscopy.
  
  
  CONCLUSIONS
  Per-oral cholecystoscopy and advanced gallbladder interventions were feasible and safe. This opens up exciting possibilities for endoscopic treatment of gallbladder pathologies.
authors.affiliation: Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
authors.forename: Shannon Melissa
authors.initials: SM
authors.lastname: Chan
authors.affiliation: Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
authors.forename: Anthony Yuen Bun
authors.initials: AYB
authors.lastname: Teoh
authors.affiliation: Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
authors.forename: Hon Chi
authors.initials: HC
authors.lastname: Yip
authors.affiliation: Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
authors.forename: Vivien Wai Yin
authors.initials: VWY
authors.lastname: Wong
authors.affiliation: Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China; Institute of Digestive Disease, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
authors.forename: Philip Wai Yan
authors.initials: PWY
authors.lastname: Chiu
authors.affiliation: Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China; Institute of Digestive Disease, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
authors.forename: Enders Kwok Wai
authors.initials: EKW
authors.lastname: Ng
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002764:Cholecystitis / Q000000981:diagnostic imaging / Q000601:surgery*; D041761:Cholecystolithiasis / Q000000981:diagnostic imaging / Q000601:surgery*; D002767:Cholecystostomy / Q000379:methods*; D004322:Drainage / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D019160:Endosonography; D005240:Feasibility Studies; D005260:Female; D005704:Gallbladder / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D000069416:Intravital Microscopy; D008297:Male; D018613:Microscopy, Confocal; D057605:Natural Orifice Endoscopic Surgery; D012189:Retrospective Studies; D015607:Stents; D025321:Surgery, Computer-Assisted