Endoscopic Ultrasound-Guided Gallbladder Drainage.

Area of Science:

• Gastroenterology and Hepatology
• Minimally Invasive Surgery
• Interventional Endoscopy

Background:

• Acute cholecystitis management primarily relies on surgery, often laparoscopic.
• A subset of patients with severe comorbidities cannot tolerate surgical intervention.
• Percutaneous gallbladder drainage has been a historical temporizing measure for these patients.

Purpose of the Study:

• To review the emerging role of endoscopic ultrasound-guided gallbladder drainage (EUS-GBD).
• To evaluate EUS-GBD as an alternative treatment for acute cholecystitis in non-surgical candidates.
• To discuss the technical aspects, challenges, and outcomes of this endoscopic approach.

Main Methods:

• Review of current literature and clinical data on endoscopic ultrasound-guided gallbladder drainage.
• Discussion of transpapillary and transmural drainage techniques.
• Analysis of technical challenges, potential adverse events, and patient outcomes.

Main Results:

• Endoscopic ultrasound-guided gallbladder drainage is an evolving technique for acute cholecystitis.
• It presents a less invasive alternative to surgery for patients with high surgical risk.
• Outcomes and adverse event profiles are being established for this method.

Conclusions:

• Endoscopic ultrasound-guided gallbladder drainage is a promising option for managing acute cholecystitis in select, high-risk patients.
• Further research and standardization are needed to define its optimal role and long-term efficacy.
• This endoscopic approach expands therapeutic options beyond traditional surgical and percutaneous methods.