Usefulness of one-step semi-deployment flushing and stenting technique for the endoscopic treatment of acute cholecystitis

Aims: Endoscopic treatment might be the treatment of choice for acute cholecystitis. We developed an one-step semi-deployed flushing and stenting technique (OSFST) for endoscopic gallbladder stenting using a 7-Fr pigtail stent. In this study, we evalutated the usefulness of OSFST.
Methods: We retrospectively evaluated the technical and clinical success rates and adverse event rates of the OSFST (transpapillary/EUS-GBD) in 44 patients who underwent an endoscopic treatment for acute cholecystitis at our hospital from April 2023 to February 2025.
Results: Transpapillary approach was performed in 34 cases and EUS approach in 10 cases. For the transpapillary approach, the cholecystic duct was selected and the guidewire was placed in the gallbladder in 88.2% (30/34). 23 patients underwent OSFST as the initial treatment. The technical success rate in transpapillary approach in cases where the cystic duct could be selected was 95.6% (22/23) and EUS approach was 100% (10/10) for OSFST. Clinical success rate was 100% for both the transpapillary and EUS approaches. The median procedure time was 33 min (range: 16-117) for the transpapillary approach and 28 min (range: 18-36) for the EUS approach, with the EUS approach being significantly shorter (P=0.03). No adverse events were observed.
Conclusions: OSFST for acute cholecystitis has a high technical and clinical success rate. It might be a useful endoscopic treatment for acute cholecystitis.