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Endoscopic Ultrasound-Guided Gallbladder Drainage for Malignant Biliary Obstruction: A Systematic Review
Padraic McDonagh1, Bidour Awadelkarim1, John S Leeds1,2
1HPB Medicine, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne NE7 7DN, UK.
Cancers
|June 10, 2023
Summary
Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) is a safe and effective rescue therapy for malignant biliary obstruction when standard treatments fail. This procedure shows an 85% success rate with a 13% adverse event rate.
Area of Science:
- Gastroenterology
- Interventional Endoscopy
- Oncology
Background:
- Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) serves as a critical rescue intervention.
- It is utilized for patients with malignant biliary obstruction unresponsive to conventional ERCP or EUS-guided biliary drainage.
- EUS-GBD is also applied in managing acute cholecystitis for non-surgical candidates.
Purpose of the Study:
- To evaluate the existing data on the safety and efficacy of EUS-guided gallbladder drainage.
- To assess its role in managing malignant biliary obstruction.
Main Methods:
- A comprehensive literature search was performed across multiple databases.
- Studies focusing on EUS-GBD for malignant biliary obstruction were included.
- Pooled success and adverse event rates were calculated with 95% confidence intervals.
Main Results:
- Seven studies involving 136 patients were analyzed.
- The pooled clinical success rate for EUS-GBD was 85% (95% CI: 78-90%).
- The pooled adverse event rate was 13% (95% CI: 7-19%), including peritonitis, bleeding, bile leakage, and stent issues. No procedure-related deaths were reported.
Conclusions:
- EUS-guided gallbladder drainage is a viable rescue option for patients with malignant biliary obstruction.
- It offers a high success rate when conventional treatments have been unsuccessful.
