EUS-guided gallbladder drainage with a lumen-apposing metal stent versus endoscopic transpapillary gallbladder drainage for the treatment of acute cholecystitis (with videos)

Should EUS-guided gallbladder drainage be preferred over endoscopic transpapillary gallbladder drainage for the treatment of acute cholecystitis in high-risk patients?

“…Although their objectives were to compare the outcomes of the procedures, the results are prone to the introduction of biases because these studies often lack a defined inclusion criterion, postprocedural management, follow-up protocol, and outcome parameters. In the current study by Higa et al, 1 differences in other factors apart from the treatment type could have accounted for the observed differences in the outcomes. The causes of cholecystitis, the duration of stent placement, the number of patients who ultimately received cholecystectomy, the lack of a defined postdrainage protocol, and the lack of reporting the durations of follow-up could all have influenced the outcomes.…”

“…In conclusion, EUS-GBD is an attractive option for gallbladder drainage that allows drainage of the gallbladder and treatment of gallstones. The efficacy of the approach in In the current study by Higa et al, 1 differences in other factors apart from the treatment type could have accounted for the observed differences in the outcomes. The causes of cholecystitis, the duration of stent placement, the number of patients who ultimately received cholecystectomy, the lack of a defined postdrainage protocol, and the lack of reporting the durations of follow-up could all have influenced the outcomes.…”

Practical Approaches for High-Risk Surgical Patients with Acute Cholecystitis: The Percutaneous Approach versus Endoscopic Alternatives

“…The recurrent AC rate was also significantly lower in the EUS-GBD group (2.6%) than in the ETGBD group (18.8%) on univariate analysis but not in a multiple regression model. 26 We can conclude that in terms of technical success, clinical success, and the adverse events rate, EUS-GBD is the best choice when compared with PTGBD and ETGBD. This procedure is especially suitable for AC patients who are indicated for permanent GB drainage.…”

“…The technical success rate was significantly higher in the EUS-GBD group than in the ETGBD group (97.5% vs. 84%, respectively). 26 The clinical success rate was also significantly higher in the EUS-GBD group (95.0% vs. 76.3%). The recurrent AC rate was also significantly lower in the EUS-GBD group (2.6%) than in the ETGBD group (18.8%) on univariate analysis but not in a multiple regression model.…”

Gall Bladder Drainage for Acute Cholecystitis in Surgically Unfit Patients: Endoscopic Ultrasound Guided Transmural Drainage or Endoscopic Transpapillary Drainage!

“…Higa JT et al have retrospectively analyzed data of 78 surgically unfit patients who were referred to their center for GB drainage. 8 They have compared technical and clinical success as well as adverse events between EUS-guided GB drainage (n = 40) and transpapillary GB drainage (n = 38). The definition and classification of AC was framed according to the Tokyo guidelines.…”