A 91-year-old female was admitted due to acute cholecystitis with choledocholithiasis.
Abdominal computer tomography (CT) revealed stones, 25 mm in diameter in the common bile (CBD) and 15 mm in diameter in the neck of the gallbladder. We attempted percutaneous transhepatic gallbladder drainage, but it was difficult to ensure a safe percutaneous puncture route.
Therefore, we performed endoscopic drainage. Endoscopic retrograde cholangiopancreatography (ERCP) revealed a stone in the CBD ; however, the cystic duct was not detected. Following this procedure, it was possible to approach the gallbladder via advancement of a guidewire ; ERCP revealed another stone in the cystic duct. Following endoscopic papillotomy, a biliary plastic stent was placed in the gallbladder and the CBD. No complications were observed following treatment, and the clinical course during recovery was good.Endoscopic transpapillary gallbladder stenting is an effective treatment for patients with acute cholecystitis who have contraindications to percutaneous drainage.
