Endoscopic ultrasonography guided gallbladder drainage: "how and when".

Area of Science:

• Gastroenterology
• Minimally Invasive Procedures
• Biliary Interventions

Background:

• Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) is an established minimally invasive technique.
• It is primarily used for acute cholecystitis in non-surgical candidates and for palliation of malignant biliary obstruction.

Purpose of the Study:

• To provide a comprehensive review of the current role of EUS-GBD.
• To compare EUS-GBD with alternative drainage methods.
• To discuss technical aspects and clinical applications.

Main Methods:

• A comprehensive literature search was conducted.
• The review focused on technical aspects, clinical scenarios, and outcomes of EUS-GBD.
• Comparison with percutaneous and endoscopic transpapillary gallbladder drainage was included.

Main Results:

• Lumen-apposing metal stents (LAMS) have expanded EUS-GBD capabilities, enabling direct gallbladder inspection and stone treatment.
• Indications for EUS-GBD have broadened.
• Studies report high technical and clinical success rates with a favorable safety profile.

Conclusions:

• Optimal EUS-GBD outcomes depend on standardized techniques and careful patient selection, ideally through multidisciplinary team decisions.
• Further prospective studies are needed to standardize indications, refine post-procedural management, and gather long-term follow-up data.