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

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.