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Related Concept Videos

Gallbladder01:17

Gallbladder

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The gallbladder is a small, pear-shaped organ that plays a crucial role in our digestive system. Measuring about 10 cm in length, it is comparable in size to a kiwi fruit and is located in a hollow area on the lower surface of the liver. The gallbladder's primary function is to store and concentrate bile, a fluid produced by the liver that aids in digestion.
The gallbladder's anatomy consists of three regions: the fundus, body, and neck. Extending from the neck, the cystic duct joins...
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Diseases of the Liver and Gallbladder01:26

Diseases of the Liver and Gallbladder

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Liver and gallbladder diseases are a significant health concern, with prominent conditions including cirrhosis, hepatitis, non-alcoholic fatty liver disease (NAFLD), and gallstones. Jaundice is a common manifestation of liver and biliary disease.
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not...
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Cavity Drainage and Flashings in Masonry walls01:20

Cavity Drainage and Flashings in Masonry walls

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Typically, a cavity wall consists of two wythes separated by a gap of at least 2 inches, which may contain insulation while still maintaining a minimum clear space of 1 inch to facilitate adequate drainage. Advanced methods like the insertion of a continuous drainage mat can further reduce this space while ensuring effective moisture expulsion.
Weep holes, strategically placed at the base of the cavity, are critical for draining accumulated water. These openings are created by leaving head...
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Rate-Determining Steps03:08

Rate-Determining Steps

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Relating Reaction Mechanisms
In a multistep reaction mechanism, one of the elementary steps progresses significantly slower than the others. This slowest step is called the rate-limiting step (or rate-determining step). A reaction cannot proceed faster than its slowest step, and hence, the rate-determining step limits the overall reaction rate.
The concept of rate-determining step can be understood from the analogy of a 4-lane freeway with a short-stretch of traffic-bottleneck caused due to...
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Energy-releasing Steps of Glycolysis01:28

Energy-releasing Steps of Glycolysis

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Glycolysis is divided into two phases based on whether energy is utilized or released. While the first phase consumes ATP, the second phase produces energy in the form of ATP and NADH. The energy is released over a sequence of reactions that turns G3P into pyruvate. The energy-releasing phase—steps 6-10 of glycolysis—occurs twice, once for each of the two 3-carbon sugars produced during steps 1-5 of the first phase.
The first energy-releasing step—the 6th step of glycolysis...
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Energy-requiring Steps of Glycolysis01:20

Energy-requiring Steps of Glycolysis

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Glucose is the source of nearly all energy used by organisms. The first step of converting glucose into usable energy is called glycolysis. Glycolysis occurs in the cytosol of the cell over two phases: an energy-requiring phase and an energy-releasing phase. Over the first three steps, glucose is converted into different forms and attached to two phosphate groups donated by two ATP molecules, resulting in an unstable sugar. In the next two stages, the unstable sugar splits into two sugar...
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Curriculum on management of acute upper gastrointestinal bleeding: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement.

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EUS-Guided Gallbladder Drainage in Acute Cholecystitis With Contained Perforation: An International Multicenter Study.

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Endosonography-guided choledochoduodenostomy using a lumen apposing metal stent vs. ERCP: Individual patient data and aggregate meta-analyses.

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Updated: Jan 28, 2026

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
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The i-EUS consensus on EUS-guided gallbladder drainage: A 3-step modified Delphi approach.

Antonio Facciorusso1, Cecilia Binda2, Stefano Francesco Crinò3

  • 1Gastroenterology Unit, Department of Experimental Medicine, University of Salento, Lecce, Italy.

Endoscopic Ultrasound
|January 26, 2026
PubMed
Summary

Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) offers a safe alternative for acute cholecystitis. This study provides evidence-based guidelines for EUS-GBD, standardizing care and improving patient outcomes.

Keywords:
EUS-guided gallbladder drainageEndosonographyGallbladder drainageLumen-apposing metal stentsPercutaneous drainage

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Area of Science:

  • Gastroenterology
  • Interventional Endoscopy
  • Medical Imaging

Background:

  • Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) is a key alternative for acute cholecystitis in non-surgical candidates.
  • Current guidelines for EUS-GBD indications, techniques, and management are limited.
  • Standardization is needed to optimize clinical decision-making and patient outcomes.

Purpose of the Study:

  • To develop evidence-based consensus recommendations for EUS-GBD.
  • To guide clinical practice in both benign and malignant conditions.
  • To improve patient outcomes through standardized EUS-GBD procedures.

Main Methods:

  • A 3-step modified Delphi process involving multidisciplinary experts.
  • Systematic literature reviews and PICO-formatted clinical questions.
  • GRADE system for evidence grading and ≥80% agreement for consensus.

Main Results:

  • Twenty-two clinical questions addressed indications, techniques, and postprocedural care.
  • EUS-GBD is recommended over percutaneous/transpapillary approaches for high-risk patients.
  • Lumen-apposing metal stents and tailored postprocedural strategies are advised.

Conclusions:

  • A comprehensive, multidisciplinary guideline for EUS-GBD is established.
  • Recommendations aim to standardize care and enhance safety and efficacy.
  • This consensus supports future research in EUS-GBD.