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Updated: Oct 16, 2025
Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
Outcomes of EUS-guided transluminal gallbladder drainage in patients without cholecystitis
Duncan J Flynn1, Zoe Memel1, Yasmin Hernandez-Barco2
1Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
Insights
Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) is a safe and effective treatment for noncholecystitis gallbladder disease in patients unfit for surgery. This minimally invasive approach shows infrequent complications and readmissions, similar to its use in acute cholecystitis.
Area of Science:
- Gastroenterology
- Endoscopic procedures
- Gallbladder disease management
Background:
- Cholecystectomy is standard for gallbladder disease, but many patients are poor surgical candidates.
- Nonsurgical gallbladder drainage (GBD) includes percutaneous cholecystostomy and endoscopic ultrasound-guided transluminal GBD (EUS-GBD).
- Outcomes for EUS-GBD in noncholecystitis (NC) gallbladder disease are not well-defined.
Purpose of the Study:
- To define the outcomes of EUS-GBD for noncholecystitis (NC) gallbladder disease.
- To evaluate the safety and efficacy of EUS-GBD in patients unsuitable for surgery.
Main Methods:
- Retrospective review of 55 EUS-GBD cases from 2015-2020 at an academic hospital.
- Included patients with acute cholecystitis, biliary colic, gallstone pancreatitis, and secondary prevention of gallstone disease.
- Analyzed complications, mortality, and reintervention rates.
Main Results:
- Fifteen of 55 EUS-GBD cases were for NC indications, including biliary colic and gallstone disease prevention.
- No statistically significant difference in complications, mortality, or reintervention compared to acute cholecystitis cases.
- The NC group had a 13.3% immediate complication rate, all managed medically.
Conclusions:
- EUS-GBD is a safe and effective option for managing NC gallbladder disease in nonsurgical candidates.
- Overall complications and readmissions were infrequent.
- EUS-GBD complication rates for NC disease are comparable to those for acute cholecystitis.
Background And Objectives:
Cholecystectomy is the gold standard for most gallbladder-related disease. However, many patients with gallbladder disease are poor surgical candidates. Current nonsurgical gallbladder drainage (GBD) methods include percutaneous cholecystostomy and endoscopic ultrasound-guided transluminal GBD (EUS-GBD). Outcomes for EUS-GBD for the treatment of noncholecystitis (NC) gallbladder disease have not been defined.
Materials And Methods:
Cases were identified using procedural data from a quaternary academic hospital for endoscopic procedures from 2015 to 2020. Patients who underwent EUS-GBD for acute cholecystitis, biliary colic, gallstone pancreatitis, and secondary prevention of gallstone disease were included.
Results:
Fifty-five cases of EUS-GBD were identified over the 5-year study period. Forty-one cases were performed for acute cholecystitis, and 15 were performed for other NC indications. Indications for NC drainage included primary treatment of symptomatic biliary colic and secondary prevention of gallstone pancreatitis and choledocholithiasis. There was no statistically significant difference in complications, mortality, or reintervention requirements. There was a 13.3% rate of immediate complications in the NC group, which were all medically managed.
Conclusions:
EUS-GBD appears to be a safe and effective way to manage gallstone disease in nonsurgical candidates with NC gallbladder-related disease. Overall complications and readmissions were infrequent. Complication rates were similar to those published in patients who underwent EUS-GBD for acute cholecystitis.
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