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Updated: Jun 17, 2025

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
07:44

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction

Published on: March 25, 2022

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Management and outcomes of antithrombotic therapy in EUS-guided gallbladder drainage

Michael Makar1, Michael Yodice1, Matt Still1

  • 1Department of Gastroenterology and Hepatology, Geisinger Medical Center, Danville, Pennsylvania, USA.

Gastrointestinal Endoscopy
|August 11, 2024
PubMed

Insights

EUS-guided gallbladder drainage is safe for patients on antithrombotic therapy (ATT). Holding ATT for the procedure did not increase bleeding, thrombotic events, or mortality risks.

Area of Science:

  • Gastroenterology
  • Interventional Endoscopy
  • Patient Safety

Background:

  • EUS-guided gallbladder drainage (EUS-GBD) is an alternative treatment for gallbladder disease in high-risk patients.
  • Patients undergoing EUS-GBD often have comorbidities requiring antithrombotic therapy (ATT).

Purpose of the Study:

  • To evaluate the safety and outcomes of EUS-GBD in patients on ATT.
  • To compare bleeding and thrombotic events in patients on ATT versus no ATT.

Main Methods:

  • Retrospective study of 177 patients undergoing EUS-GBD (2018-2023).
  • Compared outcomes between patients on ATT (held for procedure) and those not on ATT.
  • Primary outcomes: bleeding within 48 hours and 30 days. Secondary outcomes: thrombotic events, length of stay, 30-day mortality.

Main Results:

  • 118 of 177 patients were on ATT.
  • No significant difference in bleeding rates within 48 hours (0.9% vs 0%) or 30 days (3.5% vs 0%) between groups.
  • No significant differences in thrombotic events, length of stay, or 30-day mortality between groups.

Conclusions:

  • EUS-GBD can be safely performed in patients requiring ATT.
  • Appropriately holding ATT for EUS-GBD does not increase the risk of adverse events.
Abstract

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