EUS-guided transmural cholecystostomy as rescue management for acute cholecystitis in elderly or high-risk patients:...

Although EUS-guided drainage procedures have been used to collect peripancreatic fluids, little is known regarding EUS-guided transmural gallbladder drainage for high-risk patients with acute cholecystitis.

Our purpose was to evaluate the technical feasibility and outcomes of EUS-guided transmural cholecystostomy as rescue management in elderly and high-risk patients with acute cholecystitis.

Single-center prospective study.

Tertiary referral center.

Nine elderly or high-risk patients diagnosed with acute cholecystitis.

All inflamed gallbladders were drained by EUS-guided transmural cholecystostomy.

Clinical resolution of acute cholecystitis.

After the drainage procedures, there were no immediate complications such as bleeding, bile leak, or peritonitis, except for 1 patient who had pneumoperitoneum. After EUS-guided transmural cholecystostomy, all patients showed rapid clinical improvement within 72 hours.

Small number of patients.

EUS-guided transmural cholecystostomy may be feasible and safe as initial, interim, or even definitive treatment of patients with severe acute cholecystitis who are at high operative risk for immediate cholecystectomy.