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Endoscopic Gallbladder Drainage EUS LAMS vs. ERCP Trans-papillary Drainage
Maham Hayat1, Yasi Xiao1, Mustafa A Arain1
1Center for Interventional Endoscopy, AdventHealth, 601 E Rollins St, Orlando, FL, 32803, USA.
Insights
Endoscopic gallbladder drainage offers safe and effective alternatives to percutaneous drainage for acute cholecystitis in non-surgical patients. Techniques like endoscopic transpapillary gallbladder drainage and EUS-guided gallbladder drainage improve outcomes and quality of life.
Area of Science:
- Gastroenterology
- Minimally Invasive Surgery
- Endoscopy
Background:
- Acute cholecystitis requires gallbladder drainage, with cholecystectomy as the standard for surgical candidates.
- Percutaneous cholecystostomy (PTC-GBD) is a traditional drainage method for non-surgical patients.
- Endoscopic techniques have emerged as viable alternatives to PTC-GBD.
Purpose of the Study:
- To review the role of endoscopic gallbladder drainage for acute cholecystitis in non-surgical candidates.
- To describe technical aspects, clinical outcomes, and selection criteria for endoscopic gallbladder drainage.
- To compare endoscopic approaches with traditional methods.
Main Methods:
- Review of current literature on endoscopic gallbladder drainage techniques.
- Discussion of endoscopic transpapillary gallbladder drainage (ET-GBD) and endoscopic ultrasound-guided gallbladder drainage (EUS-GBD).
- Comparison of outcomes and quality of life with percutaneous cholecystostomy (PTC-GBD).
Main Results:
- ET-GBD and EUS-GBD are effective and safe alternatives to PTC-GBD.
- Endoscopic methods demonstrate improved patient quality of life compared to percutaneous approaches.
- Growing evidence supports the efficacy and safety of endoscopic gallbladder drainage.
Conclusions:
- Endoscopic gallbladder drainage is a valuable option for non-surgical patients with acute cholecystitis.
- The choice of endoscopic technique should be individualized based on clinical scenario and endoscopist preference.
- A multidisciplinary approach is recommended for optimal patient management.
Purpose Of Review:
In this review, we discuss the role of endoscopic gallbladder drainage for acute cholecystitis in non-surgical candidates, describe technical aspects, clinical outcomes, and elaborate on considerations when determining which approach to adopt for a given patient.
Recent Findings:
Cholecystectomy remains the criterion standard for management of acute cholecystitis in patients who can safely undergo surgery. For non-surgical candidates, percutaneous cholecystostomy (PTC-GBD) has been the traditional strategy to drain and decompress the gallbladder. Advances in endoscopy have further expanded the nonsurgical interventions and approaches to cholecystitis. Both endoscopic transpapillary gallbladder drainage (ET-GBD) and endoscopic ultrasound guided gallbladder drainage (EUS-GBD) have become acceptable alternatives to PTC-GBD, with growing literature supporting their efficacy, safety and improved patient quality of life when compared to a percutaneous approach. Choosing the appropriate endoscopic technique for gallbladder drainage should be tailored to each patient, keeping in view the specific clinical scenarios, endoscopist preference and following a multi-disciplinary approach.
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