Endoscopic Gallbladder Drainage: A Comprehensive Review on Indications, Techniques, and Future Perspectives

Area of Science:

• Gastroenterology
• Interventional Endoscopy
• Biliary Tract Interventions

Background:

• Therapeutic endoscopy is a minimally invasive, effective, and safe approach for gallbladder diseases.
• Endoscopic transpapillary gallbladder drainage (TGBD) and endoscopic ultrasound (EUS)-guided gallbladder drainage (EUS-GBD) offer internal drainage for acute cholecystitis, superior to percutaneous gallbladder drainage (PGBD).

Purpose of the Study:

• To review endoscopic gallbladder drainage techniques, TGBD and EUS-GBD.
• To compare the clinical efficacy of endoscopic gallbladder drainage with PGBD.
• To discuss future perspectives and uncertainties in EUS-GBD.

Main Methods:

• Review of existing literature on TGBD and EUS-GBD.
• Comparison of endoscopic techniques with PGBD for acute cholecystitis.
• Evaluation of EUS-GBD with lumen-apposing metal stents (LAMS) for interventions and rescue therapy.

Main Results:

• EUS-GBD with LAMS has expanded endoscopic therapies for acute cholecystitis, improving ease and availability.
• EUS-GBD enables cholecystoscopy-guided interventions like gallstone lithotripsy and clearance.
• EUS-GBD shows promise as a rescue therapy for malignant biliary obstruction.

Conclusions:

• Endoscopic gallbladder drainage, particularly EUS-GBD with LAMS, is a valuable tool for gallbladder diseases.
• EUS-GBD offers versatile treatment options beyond simple drainage.
• Further research is needed to address current uncertainties regarding EUS-GBD.