EUS-guided Versus Percutaneous Gallbladder Drainage: Isn't It Time to Convert?

Area of Science:

• Gastroenterology
• Minimally Invasive Procedures
• Interventional Endoscopy

Background:

• Cholecystitis management for non-surgical candidates often involves drainage.
• Percutaneous gallbladder drainage (PC-GLB) is a common approach.
• Endoscopic ultrasound-guided gallbladder drainage (EUS-GLB) is an emerging minimally invasive alternative.

Purpose of the Study:

• To compare the efficacy and safety of EUS-GLB versus PC-GLB in non-surgical patients with cholecystitis.
• To evaluate technical success, clinical success, adverse events, and need for repeat interventions.

Main Methods:

• Multicenter, international retrospective study including 155 patients (2010-2015).
• Patients underwent either PC-GLB or EUS-GLB.
• Outcomes assessed included technical/clinical success, adverse events, length of stay, and repeat interventions.

Main Results:

• Technical success rates were high and comparable (95% EUS-GLB vs. 99% PC-GLB).
• Clinical success rates were also similar (95% EUS-GLB vs. 86% PC-GLB).
• EUS-GLB demonstrated a significantly lower rate of repeat interventions (10% vs. 24%, P=0.037) without increased adverse events.

Conclusions:

• EUS-GLB is a safe and effective treatment for cholecystitis in non-surgical patients.
• EUS-GLB shows comparable success rates to PC-GLB but with fewer repeat interventions.
• EUS-GLB offers potential morbidity and cost benefits due to reduced need for re-intervention.