EUS-guided gallbladder drainage using a lumen-apposing self-expandable metal stent in patients with coagulopathy or...

Area of Science:

• Gastroenterology
• Interventional Endoscopy
• Medical Device Technology

Background:

• Gallbladder drainage is crucial for patients with acute cholecystitis.
• Traditional surgical or percutaneous drainage may pose risks for patients with prohibitive surgical risk, coagulopathy, or on anticoagulation.
• Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) offers a minimally invasive alternative.

Observation:

• This study evaluated the emergent use of EUS-GBD in four patients with severe comorbidities.
• All patients had prohibitive surgical risk due to factors including coagulopathy or anticoagulant use.
• An electrocautery-enhanced lumen-apposing self-expanding metal stent (LA-SEMS) was utilized for drainage.

Findings:

• The emergent EUS-GBD procedure was technically successful in all four patients.
• No major complications were reported during or after the procedure.
• LA-SEMS provided effective gallbladder drainage in this challenging cohort.

Implications:

• Electrocautery-enhanced LA-SEMS may be a viable and safe option for emergent gallbladder drainage in high-risk patients.
• This technique expands the utility of EUS-guided interventions in complex clinical scenarios.
• Further research is warranted to confirm safety and efficacy in larger patient populations.