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Kahaleh M et al. – The ideal placement of a CSEMS is below the cystic duct insertion. Should the cystic duct ostium be occluded, placement of a GBS should be considered to minimize the risk of cholecystitis.

Exclusive Author Commentary
Michel Kahaleh, 11/10/09

Gallbaldder stenting is a challenging option, which should be undertaken by dedicated interventional endoscopists whenever the cystic duct insertion is blocked by a covered SEMS. Another possible alternative might include placing an uncovered SEMS, although no trial demonstrated clear decrease in incidence of cholecystitis with this option.

   

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