40A Case of EUS-Guided Gallbladder Drainage Using a Novel Fully Covered Metal Stent after Endobiliary Radiofrequency Ablation
Jin Ho Choi, Tae Seung Lee, Chang Hyun Kim, Eun Jeong Kim, In Rae Cho, Woo Hyun Paik, Ji Kon Ryu, Sang Hyub LeeAbstract
Background & Objectives
Acute cholecystitis is a recognized complication following endobiliary interventions, including endoscopic radiofrequency ablation (RFA), particularly in patients with advanced biliary malignancies who are poor surgical candidates. Endoscopic ultrasound (EUS)-guided gallbladder drainage has emerged as a minimally invasive alternative to percutaneous or surgical approaches. We report a case of acute cholecystitis after endobiliary RFA successfully managed with EDS-guided gallbladder drainage using a novel fully covered metal stent.
Method
A 59-year-old woman with unresectable hilar cholangiocarcinoma undergoing palliative chemotherapy presented with fever and right upper quadrant abdominal pain three days after endobiliary RFA and biliary drainage revision. Laboratory tests showed leukocytosis, elevated inflammatory markers, and cholestatic liver enzyme abnormalities. Computed tomography demonstrated gallbladder distension with wall thickening, consistent with acute cholecystitis. Given the patient's high surgical risk, EDS-guided gallbladder drainage was performed using a novel fully covered metal stent.
Results
The procedure was technically successful without immediate adverse events. The patient experienced rapid clinical improvement, including resolution of fever and abdominal pain. Inflammatory markers and liver function tests showed marked improvement. Follow-up imaging confirmed effective gallbladder decompression, and the patient remained clinically stable during subsequent outpatient follow-up.
Conclusion
EDS-guided gallbladder drainage using a novel fully covered metal stent appears to be a feasible and effective minimally invasive treatment option for acute cholecystitis following endobiliary procedures in high-risk patients with advanced biliary malignancy.