Endoscopic Management of Acute Cholecystitis

Area of Science:

• Gastroenterology
• Minimally Invasive Surgery
• Endoscopic Procedures

Background:

• Acute cholecystitis management often involves cholecystectomy, which poses risks for high-risk patients.
• Transpapillary and endoscopic ultrasound (EUS)-guided gallbladder drainage (EUS-GBD) are endoscopic alternatives.
• EUS-GBD is increasingly favored for high-risk individuals due to its efficacy and safety profile.

Purpose of the Study:

• To review the current landscape of EUS-GBD for acute cholecystitis.
• To discuss indications, techniques, and stent systems used in EUS-GBD.
• To compare EUS-GBD outcomes with conventional treatments and laparoscopic cholecystectomy.

Main Methods:

• Review of current literature and clinical data on EUS-GBD.
• Analysis of indications, procedural techniques, and lumen-apposing metal stent (LAMS) systems.
• Comparative outcome analysis of EUS-GBD versus percutaneous drainage and laparoscopic cholecystectomy.

Main Results:

• EUS-GBD demonstrates high technical and clinical success rates.
• The procedure is associated with a low rate of adverse events.
• Initial data suggests comparable outcomes to laparoscopic cholecystectomy in select patients.

Conclusions:

• EUS-GBD is a viable and effective treatment option for acute cholecystitis, particularly in high-risk surgical candidates.
• Advancements in stent technology have improved the safety and success of EUS-GBD.
• Further comparative studies support EUS-GBD as an alternative to surgery in specific patient populations.