Safety of EUS-guided gallbladder drainage using a lumen-apposing metal stent in patients requiring anticoagulation

Area of Science:

• Gastroenterology
• Interventional Endoscopy

Background:

• Acute cholecystitis management often requires surgery, but some patients have comorbidities preventing operative intervention.
• Percutaneous gallbladder drainage was a historical nonsurgical approach for cholecystitis.
• Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) offers a minimally invasive alternative.

Purpose of the Study:

• To evaluate the periprocedural bleeding rate of EUS-GBD in patients with acute cholecystitis who require anticoagulation.
• To assess the safety of EUS-GBD in high-surgical-risk patients.

Main Methods:

• Retrospective analysis of 5 high-surgical-risk patients with acute cholecystitis undergoing EUS-GBD.
• Patients required anticoagulation therapy.
• Use of lumen-apposing metal stents for gallbladder drainage.

Main Results:

• No immediate or delayed adverse events were observed postprocedure.
• Specifically, no instances of bleeding occurred during or after the EUS-GBD procedure.
• The technique demonstrated a favorable safety profile in this cohort.

Conclusions:

• EUS-GBD appears to be a safe treatment option for acute cholecystitis in patients requiring periprocedural anticoagulation.
• Further research is warranted to confirm these findings in larger patient populations.
• EUS-GBD provides a viable nonsurgical management strategy for select patients.