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World J Gastroenterol. Jan 7, 2024; 30(1): 70-78
Published online Jan 7, 2024. doi: 10.3748/wjg.v30.i1.70
Use of endoscopic ultrasound-guided gallbladder drainage as a rescue approach in cases of unsuccessful biliary drainage
Alessandro Fugazza, Kareem Khalaf, Katarzyna M Pawlak, Marco Spadaccini, Matteo Colombo, Marta Andreozzi, Marco Giacchetto, Silvia Carrara, Chiara Ferrari, Cecilia Binda, Benedetto Mangiavillano, Andrea Anderloni, Alessandro Repici
Alessandro Fugazza, Marco Spadaccini, Matteo Colombo, Marta Andreozzi, Marco Giacchetto, Silvia Carrara, Alessandro Repici, Division of Gastroenterology and Digestive Endoscopy, Humanitas Research Hospital - IRCCS, Rozzano 20089, Milano, Italy
Kareem Khalaf, Katarzyna M Pawlak, Division of Gastroenterology, St. Michael’s Hospital, University of Toronto, Toronto M5B 1W8, ON, Canada
Chiara Ferrari, Department of Anesthesia, Humanitas Research Hospital - IRCCS, Rozzano 20089, Milano, Italy
Cecilia Binda, Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, Romagna 47121, Italy
Benedetto Mangiavillano, Gastrointestinal Endoscopy Unit, Humanitas Mater Domini, Castellanza 21100, Italy
Andrea Anderloni, Gastroenterology and Digestive Endoscopy Unit, Fondazione IRCCS Policlinico San Matteo, Pavia 27100, Italy
Author contributions: Fugazza A and Repici A contributed to the conceptualization of this manuscript; Khalaf K and Pawlak KM involved in the data curation and writing-original draft preparation; Fugazza A, Spadaccini M, Colombo M, Andreozzi M, Giacchetto M, Carrara S, Ferrari C, Binda C, Mangiavillano B, and Anderloni A participated in the writing-review and editing, and acquisition of data; and all authors have read and agreed to the published version of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Marco Spadaccini, MD, Consultant Physician-Scientist, Postdoctoral Fellow, Researcher, Division of Gastroenterology and Digestive Endoscopy, Humanitas Research Hospital - IRCCS, via Manzoni 56, Rozzano 20089, Milano, Italy. marcospadaccini9@gmail.com
Received: August 23, 2023
Peer-review started: August 23, 2023
First decision: October 8, 2023
Revised: November 14, 2023
Accepted: December 22, 2023
Article in press: December 22, 2023
Published online: January 7, 2024
Abstract

This narrative review provides an overview of the utilization of endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) as a salvage approach in cases of unsuccessful conventional management. EUS-GBD is a minimally invasive and effective technique for drainage in patients with acute cholecystitis with high risk of surgery. The procedure has demonstrated impressive technical and clinical success rates with low rates of adverse events, making it a safe and effective option for appropriate candidates. Furthermore, EUS-GBD can also serve as a rescue option for patients who have failed endoscopic retrograde cholangiopancreatography or EUS biliary drainage for relief of jaundice in malignant biliary stricture. However, patient selection is critical for the success of EUS-GBD, and proper patient selection and risk assessment are important to ensure the safety and efficacy of the procedure. As the field continues to evolve and mature, ongoing research will further refine our understanding of the benefits and limitations of EUS-GBD, ultimately leading to improved outcomes for patients.

Keywords: Endoscopic ultrasound-guided gallbladder drainage, Gallbladder drainage, Acute cholecystitis, Malignant obstruction, Interventional endoscopic ultrasound, Lumen-apposing metal stents

Core Tip: This review article explores the use of a minimally invasive procedure called endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) as a salvage technique for cases of unsuccessful biliary drainage (BD) with conventional approach. EUS-GBD has been shown to be effective in relieving biliary obstruction in patients who have failed other treatment options such as endoscopic retrograde cholangiopancreatography and EUS BD. The article summarizes the safety and efficacy of EUS-GBD in various studies, and discusses its potential advantages and limitations compared to other drainage options. The authors aim to offer a comprehensive overview of the potential role of EUS-GBD for various indications as a rescue therapy for malignant biliary obstruction when conventional treatment options fail, and to provide insights into the challenges and limitations associated with the procedure.