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Updated: Jan 13, 2026
Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
Outcomes of Endoscopic Ultrasound-Guided Gallbladder Drainage Using Lumen-Apposing Metal Stent Performed by Early
Suchapa Arayakarnkul1, Natalie Wilson1, Amir Rumman2
1Department of Internal Medicine, University of Minnesota, Minneapolis, MN, USA.
Background And Aims:
Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) has gained popularity for acute cholecystitis (AC) management in patients deemed unfit for surgery. Recent studies have found > 95% technical success and > 90% clinical success when performed by experienced advanced endoscopists. Recently, the U.S. Food and Drug Administration (FDA) approved the use of lumen-apposing metal stent (LAMS) for EUS-GBD. The aim of this study is to evaluate the safety and efficacy of EUS-GBD performed by early-career advanced endoscopists in North America.
Methods:
This was a retrospective multicenter study of patients who underwent EUS-GBD performed by 8 early-career advanced endoscopists (defined as within 3 years of graduation from advanced endoscopy fellowship (AEF)) between January 2021 and March 2024. Primary outcomes included technical success (ability to place LAMS into the gallbladder) and clinical success (resolution of symptoms and laboratory abnormalities). Secondary outcomes included adverse events (AEs) and 30-day readmission rates.
Results:
A total of 57 patients (mean age 70.7 years, 59.6% male) were included. The most common site of EUS-GBD was the duodenum (57.9%) and LAMS size 10 × 10 mm (71.9%). The technical success rate was 98.2%, and the clinical success rate was 98.2%. AEs occurred in 3.5% (n = 2), including gallbladder perforation and recurrent AC following stent migration. The 30-day readmission rate was 5.3% (n = 3). There was no procedure-related mortality.
Conclusions:
Our study demonstrates that EUS-GBD is safe and effective when performed by early-career advanced endoscopists. These outcomes are similar to previous data when performed by experienced advanced endoscopists.
