Long-Term Outcomes of Endoscopic Transpapillary Gallbladder Stenting for Symptomatic Cholelithiasis.

Background and Aims: Long-term outcomes of endoscopic transpapillary gallbladder stenting (ETGS) for symptomatic cholelithiasis are unclear. This study aimed to clarify these outcomes of patients with high surgical risks. Methods: This single-center study included patients with symptomatic cholelithiasis who underwent ETGS between January 2017 and December 2023. Patient background characteristics, endoscopic procedures, stent type used for ETGS, and clinical course were retrospectively assessed. A late adverse event (LAE) was defined as a symptomatic event related to ETGS that occurred more than 2 weeks postoperatively. The frequency of LAEs, LAE-free survival rate, and risk factors for LAEs were analyzed. Results: A total of 100 patients (median age, 81 years; 57 male and 43 female patients) were included in the analysis. The LAE rate was 27.0% (27/100). LAEs comprised cholangitis (n = 16), solitary cholecystitis (n = 9), solitary liver abscess (n = 1), and cystic artery pseudoaneurysm (n = 1). The estimated 1-year, 2-year, and 3-year LAE-free rates were 88.7%, 80.3%, and 76.7%, respectively, and the estimated median time to LAEs was 5.3 years. Compared with cutoff endoscopic nasobiliary drainage tube placement, IYO-stent placement (hazard ratio, 0.19; 95% confidence interval, 0.07-0.56; Conclusion: Long-term ETGS with regular follow-up can be safe and effective for patients with high surgical risks and symptomatic cholelithiasis. The use of the IYO-stent was independently associated with a decreased risk of LAEs and potentially contributed to improved long-term LAE-free survival.