Use of endoscopic ultrasound-guided gallbladder drainage as a rescue approach in cases of unsuccessful biliary drainage

Table 4 A table comparing the advantages and limitations of endoscopic ultrasound-guided gallbladder drainage with other drainage options in case of distal malignant biliary obstruction

Drainage option	Advantages	Limitations
ERCP	Established technique, high success rates, can manage multiple strictures	Limited by anatomy, requires skilled operators, can cause pancreatitis
PTBD	High technical success rate, effective in cases of ERCP failure and altered anatomy	Associated with higher complication rates, requires external drainage, decreased quality of life, risk of multiple reintervention
EUS-BD	Access intrahepatic or extrahepatic duct, no risk of pancreatitis, can manage failed ERCP cases	Limited availability, requires skilled operators, higher cost
EUS-GBD	Can avoid transpapillary access, can manage acute cholecystitis, can manage failed ERCP and EUS-BD cases	Limited data on long-term outcomes, risk of gallbladder perforation or bleeding, limited applicability in cases of obstructed cystic duct

EUS-GBD: Endoscopic ultrasound-guided gallbladder drainage; PTBD: Percutaneous transhepatic biliary drainage; EUS-BD: Endoscopic ultrasound biliary drainage; ERCP: Endoscopic retrograde cholangiopancreatography.