Background: Laparoscopic cholecystectomy (LC) has become the ââ?¬Ë?gold standardââ?¬â?¢ for the treatment of symptomatic\ngallstones. Innovative methods are being introduced, and these procedures include transgastric or transcolonic\nendoscopic cholecystectomy. However, before clinical implementation, instruments still need modification, and a more\nconvenient treatment is still needed. Moreover, some gallbladders still have good functionality and cholecystectomy\nmay be associated with various complications. The aim of this study was to evaluate the trans-gastrointestinal tract\ncholecystoscopy technique in the treatment of gallbladder disease without cholecystectomy.\nMethod: Endoscopic ultrasound (EUS)-guided cholecystoduodenostomy or cholecystogastrostomy with the placement\nof a double-flanged fully covered metal stent was performed and endoscopic sphincterotomy (EST) was also performed\nduring this procedure for those patients with accompanying common bile duct stones. One or two weeks later the stent\nwas removed and an endoscope was advanced into the gallbladder via the fistula, and cholecystolithotomy or polyp\nresection was performed. Four weeks later gallbladder was assessed by abdominal ultrasound.\nResults: EUS guided cholecystoduodenostomy (n = 3) or cholecysto gastrostomy (n = 4) with double flanged mental stent\ndeployment was successfully performed in all of 7 patients. After the procedure, fistulas had formed in each of the\npatients and the stents were removed. Endoscopic cholecystolithotomy(7) and polyps resection(2) were successfully\nperformed through the fistulas. Common bile duct stones were also successfully removed in 5 patients. The ultrasound\nexamination of the gallbladder 4 weeks later showed no stones remaining and also showed satisfactory functioning of\nthe gallbladder.\nConclusion: The EUS-guided placement of a novel metal stent is a safe and simple approach for performing an\nendoscopic cholecystoduodenostomy or cholecysto gastrostomy, which can subsequently allow procedures to\nbe performed for treating biliary disease, including cholecystolithotomy.
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