Endoscopic management of acute cholecystitis after metal stent placement in patients with malignant biliary obstruction: A case series

摘要

Acute cholecystitis is a complication of biliary self-expandable metallic stent (SEMS) placement and results from obstruction of the cystic duct.1 The incidence of acute cholecystitis in this setting ranges between 1.9% and 12%. 1~14 Tumor involvement of the cystic duct orifice is a risk factor for acute cholecystitis after SEMS placement.1 Theoretically, uncovered stents with their open interstices should allow for sufficient gallbladder drainage to avoid cholecystitis. However, the incidence of cholecystitis was similar between covered and uncovered SEMSs in 2 recent meta-analyses.15'16 The absolute rates of acute cholecystitis in this setting is likely to increase with the widespread use of biliary SEMSs. Endoscopic management of cholecystitis after SEMS placement has not been described. Here we report a case series of 4 patients with acute cholecystitis after SEMS placement who underwent successful endoscopic management.