Technical issues stemming from endoscopic-ultrasound-guided gallbladder drainage: A single center experience

Area of Science:

• Gastroenterology
• Interventional Endoscopy
• Biliary Interventions

Background:

• Acute cholecystitis management often requires gallbladder drainage.
• Endoscopic-ultrasound-guided gallbladder drainage (EUS-GBD) is an alternative to traditional methods.
• Evaluation of EUS-GBD outcomes using non-lumen-apposing stents is crucial.

Purpose of the Study:

• To assess the clinical outcomes of EUS-GBD with traditional biliary stents.
• To identify and analyze technical difficulties encountered during EUS-GBD.
• To develop technical countermeasures for improved EUS-GBD procedures.

Main Methods:

• Retrospective analysis of 18 patients undergoing EUS-GBD (2012-2018).
• Evaluation of technical success, clinical effectiveness, adverse events, and recurrence.
• Development of technical solutions based on observed complications.

Main Results:

• High technical success (94%) and clinical effectiveness (88%) rates were achieved.
• Severe adverse events (massive bile leakage) occurred in 6% of patients.
• Technical difficulties included scope instability, non-swollen gallbladder, and stent migration, with a 27% recurrence rate.

Conclusions:

• EUS-GBD with traditional stents yields relatively favorable clinical outcomes.
• Specific technical issues, such as stent positioning and migration, require attention.
• Implementing targeted technical countermeasures can enhance EUS-GBD efficacy and safety.