Novel Catheter Improves Endoscopic Transpapillary Gallbladder Drainage in Malignant Biliary Stricture VideoGIE | July 2026

Introduction: Acute cholecystitis in patients with malignant biliary obstruction can be difficult to manage, particularly when surgery is not feasible. Endoscopic transpapillary gallbladder drainage (ETGBD) is an attractive minimally invasive option, but selective cannulation of the cystic duct remains technically challenging. This video case demonstrates the use of a novel ETGBD catheter to facilitate successful gallbladder drainage.

Why was this technique needed?

• ETGBD is technically demanding because of difficult cystic duct cannulation.
• Malignant biliary strictures further reduce the success of conventional drainage.
• Many patients are poor surgical candidates.
• Safer and more reliable endoscopic accessories are needed.
• Improved devices may increase the success of minimally invasive gallbladder drainage.

Key Technical Points:

• A novel dedicated catheter enabled successful navigation through the cystic duct despite malignant distal biliary obstruction.
• The device facilitated successful endoscopic transpapillary gallbladder drainage, avoiding the need for percutaneous drainage or surgery.
• The technique demonstrates the potential of specialized accessories to improve the technical success of ETGBD in complex biliary anatomy.

Clinical Impact:

Endoscopic transpapillary gallbladder drainage is an important alternative for patients with acute cholecystitis and malignant biliary obstruction. The availability of dedicated devices may simplify technically difficult procedures, expand the applicability of ETGBD, and reduce dependence on percutaneous drainage.

Bottom Line:

Novel ETGBD accessories can improve the success of endoscopic gallbladder drainage in patients with malignant biliary strictures. As dedicated devices continue to evolve, ETGBD may become an increasingly practical minimally invasive option for high-risk patients.