EUS -guided Biliary Drainage in acute cholecystitis(GIE, Jan-2026)

The article discusses the efficacy and clinical durability of EUS-guided gallbladder drainage (EUS-GBD) as a treatment for acute cholecystitis in high-risk surgical patients. Acute cholecystitis, which is an inflammation of the gallbladder, is traditionally treated with surgical intervention. However, in patients who are not candidates for surgery due to high risk, EUS-GBD has emerged as a reliable alternative. This minimally invasive procedure has been supported by recent guidelines over percutaneous transhepatic gallbladder drainage (PTGBD) in such cases.

The study systematically analyzed data from 18 studies, including 701 patients, with follow-up periods exceeding 1 year. The technical success rate of EUS-GBD was 95.8%, and the clinical success rate was 94.3%. Recurrence of cholecystitis was low (4.2%), while readmission rates were 19% and reintervention rates were 6%. Stent patency was observed for an average of 418.8 days, and the need for repeat endoscopy due to stent obstruction or occlusion was minimal (2.9%). Overall, the procedure showed a low rate of adverse events.

In conclusion, EUS-GBD is a technically effective, clinically durable, and safe treatment for acute cholecystitis in high-risk patients, offering a viable alternative to traditional surgical approaches with sustained long-term outcomes.