EUS-guided gallbladder drainage in acute cholecystitis: long-term problems with surgical approach

Message Professional societies have endorsed endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) as an alternative to percutaneous cholecystostomy in high-risk surgical patients with acute cholecystitis. In a retrospective case series, we encountered 3 of 25 patients who improved clinically after EUS-GBD and subsequently had their surgical risk status reversed when cholecystectomy was indicated due to persistent symptoms. However, the presence of a lumen-apposing metal stent (LAMS) precluded a minimally invasive surgical approach and necessitated conversion to open or subtotal cholecystectomy. Therefore, EUS-GBD should be reserved for a selective cohort of never-surgery patients and not for all patients broadly stratified as high-risk surgical candidates. In more detail Randomised trials and meta-analysis comparing EUS-GBD using LAMS versus percutaneous cholecystostomy in high-risk surgical patients with acute cholecystitis have favoured EUS-GBD as it is associated with lower rates of adverse events, reinterventions and readmissions.1 2 Therefore, the European...
Source: Gut - Category: Gastroenterology Authors: Tags: Open access, Gut Endoscopy news Source Type: research