Feasibility of a novel 5F plastic stent in endoscopic transpapillary gallbladder drainage for acute cholecystitis.

Background and study aims: Many reports have demonstrated the efficacy of endoscopic transpapillary gallbladder stenting (EGBS) for acute cholecystitis (AC), most of which have traditionally used a 7F plastic stent. The study aim was to evaluate the efficacy of a novel 5F plastic stent in EGBS for AC. Patients and methods: We designed a retrospective study that compared the outcomes between 7F and 5F stents in patients undergoing EGBS. Among 147 patients who underwent endoscopic transpapillary gallbladder drainage for AC between January 2019 and July 2023, 104 who underwent EGBS using a 7F (n = 53) or 5F (n = 51) plastic stent were included in the analysis. Results: The technical success rate for EGBS, clinical success rate for AC, and early adverse events (AEs) rate in the 7F and 5F groups were 92.5% vs 100%, 100% vs 98.0%, and 5.7% vs 3.9%, respectively, with no significant differences. However, only in the 7F group, four patients failed stent insertion and three patients developed postprocedure pancreatitis. Furthermore, incidence of hyperamylasemia was lower in the 5F group (24.5% vs 9.8%, P = 0.047). The late AE rate did not differ significantly between the 7F and 5F groups (14.3% vs 10.0%). The median time to late AE was 238 days for the 7F group and 187 days for the 5F group, with no significant difference. Conclusions: A 5F stent can provide outcomes comparable to those of a 7F stent and help prevent hyperamylasemia.