# Successful Management of Recurrent Cholecystitis Four Years After Endoscopic Gallbladder Stenting (EGBS) Placement Using Internal and External Fistula Drainage

## TL;DR

This case study shows a successful treatment for recurring gallbladder inflammation after a stent was placed four years earlier.

## Contribution

The paper introduces a novel endoscopic technique using an existing stent to manage recurrent cholecystitis after EGBS.

## Key findings

- ETGBD was successfully performed using the existing EGBS for guidewire access.
- Combined internal and external drainage improved clinical outcomes in this patient.
- The approach may be especially useful when dealing with purulent bile.

## Abstract

Recurrent cholecystitis can occur even after permanent endoscopic gallbladder stenting (EGBS), and optimal management in such situations remains challenging. In the present case, endoscopic transpapillary gallbladder drainage (ETGBD) was successfully achieved by using the indwelling EGBS to facilitate guidewire access to the gallbladder. Endoscopic nasobiliary gallbladder drainage was also placed, enabling combined internal and external drainage. The patient experienced a favorable clinical course following this approach. This case suggests that ETGBD is a feasible therapeutic option for recurrent cholecystitis after permanent EGBS placement, with the pre-existing stent aiding in gallbladder cannulation. Combined drainage may be particularly advantageous in the setting of purulent bile to ensure effective decompression.