EUS-guided gallbladder drainage as a treatment for acute perforated cholecystitis

Area of Science:

• Gastroenterology
• Interventional Endoscopy
• Surgical Complications

Background:

• Acute perforated cholecystitis is a severe complication of acute cholecystitis.
• Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) using lumen-apposing metal stents (LAMS) is the standard for high-risk patients unfit for surgery.
• Concerns exist regarding EUS-GBD safety in cases of suspected gallbladder perforation or necrosis.

Discussion:

• This case report highlights the successful application of EUS-GBD with LAMS in managing type II gallbladder perforation.
• The procedure demonstrated efficacy despite contraindications often associated with gallbladder perforation.
• This challenges the notion that EUS-GBD should be avoided in such scenarios.

Key Insights:

• EUS-GBD with LAMS is a feasible and effective treatment for type II gallbladder perforation.
• The study expands the evidence base for EUS-GBD in complex cholecystitis cases.
• Successful management was achieved in a high-risk patient unsuitable for traditional surgery.

Outlook:

• Further research is warranted to establish definitive guidelines for EUS-GBD in perforated cholecystitis.
• Investigating the long-term outcomes of EUS-GBD in perforated gallbladder cases is crucial.
• This technique may become a more widely accepted alternative to surgery for select patients.