EUS-guided gallbladder drainage in acute cholecystitis

EUS-guided gallbladder drainage (EUS-GBD) has emerged as a valuable and reliable treatment option for patients with acute cholecystitis who are considered high-risk for surgical intervention. Acute cholecystitis, an inflammation of the gallbladder typically caused by gallstones, can lead to serious complications if untreated. While surgery remains the standard treatment, certain patients, such as those with significant comorbidities or poor overall health, may not be suitable candidates for surgical procedures. In these cases, EUS-GBD provides an effective alternative.

EUS-GBD involves the use of endoscopic ultrasound to place a stent, creating a drainage pathway from the gallbladder to the gastrointestinal tract. This approach eliminates the need for external drainage, as seen in percutaneous transhepatic gallbladder drainage, and offers a minimally invasive solution with fewer complications. Guidelines now recommend EUS-GBD over percutaneous drainage due to its safety and efficacy.

Studies have shown that EUS-GBD achieves high rates of technical and clinical success, with durable outcomes over long-term follow-up. It is associated with low rates of adverse events, such as stent obstruction or infection, and provides effective symptom relief while reducing the need for repeat interventions or hospital readmissions. Overall, EUS-GBD represents a transformative option for managing acute cholecystitis in high-risk surgical patients.