Recurrence rate of cholecystitis after initial gallbladder stenting versus secondary gallbladder stenting: A propensity score matching study

Objective: Limitations are sometimes encountered in the application of laparoscopic cholecystectomy to the treatment of acute cholecystitis. Endoscopic gallbladder stenting (EGBS) has emerged as an additional option. However, the long-term stent patency remains an issue. This study was performed to compare the efficacy of primary and secondary EGBS.

Methods: Sixty-one patients who underwent preplanned EGBS because of poor surgical tolerance from January 2006 to July 2023 were retrospectively analyzed. The patients were divided into the initial EGBS group, in which EGBS was performed as the first option (n = 37), and the secondary EGBS group, in which EGBS was performed following other treatments (n = 24). The primary endpoint was the 3-month recurrence rate, and the secondary endpoint was the technical success rate. Propensity score matching was performed to align the patients' background factors between the two groups.

Results: After propensity score matching, six patients from each group were selected for analysis. The technical success rate was significantly higher in the secondary EGBS group (73.0% [27/37] vs. 95.8% [23/24], respectively). Furthermore, the 3-month recurrence rate was significantly higher in the initial than secondary EGBS group (66.7% [4/6] vs. 0.0% [0/6], respectively; p = 0.0232).

Conclusion: Secondary EGBS may effectively prevent recurrent cholecystitis in patients with poor surgical tolerance.