Clinical Endoscopy

Joey Ho Yi Chan

1 Article

Current Status of Endoscopic Gallbladder Drainage: Joey Ho Yi Chan, Anthony Yuen Bun Teoh; Clin Endosc 2018;51(2):150-155. Published online November 17, 2017; DOI: https://doi.org/10.5946/ce.2017.125

The gold standard for treatment of acute cholecystitis is laparoscopic cholecystectomy. However, cholecystectomy is often not suitable for surgically unfit patients who are too frail due to various co-morbidities. As such, several less invasive endoscopic treatment modalities have been developed to control sepsis, either as a definitive treatment or as a temporizing modality until the patient is stable enough to undergo cholecystectomy at a later stage. Recent developments in endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) with endoscopic ultrasound (EUS)-specific stents having lumen-apposing properties have demonstrated potential as a definitive treatment modality. Furthermore, advanced gallbladder procedures can be performed using the stents as a portal. With similar effectiveness as percutaneous transhepatic cholecystostomy and lower rates of adverse events reported in some studies, EUS-GBD has opened exciting possibilities in becoming the next best alternative in treating acute cholecystitis in surgically unfit patients. The aim of this review article is to provide a summary of the various methods of gallbladder drainage (GBD) with particular focus on EUS-GBD and the many new prospects it allows.

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