Gallbladder drainage guided by endoscopic ultrasound

Abstract

The gold-standard management of acute cholecystitis is cholecystectomy. Surgical intervention may be contraindicated due to permanent causes. To date, the classical approach is percutaneous cholecystostomy in patients unresponsive to medical therapy. However, with this treatment some patients may experience discomfort, complications and a decrease in their quality of life. In these cases, endoscopic ultrasound (EUS)-guided gallbladder drainage may represent an effective minimally invasive alternative. Our objective is to describe in detail this new and not well-known technique: EUS-guided cholecystenterostomy. We will describe how the patient should be prepared, what accessories are needed and how the technique is performed. We will also discuss the possible indications for this technique and will provide a brief review based on published reports and our own experience.

Keywords: Gallbladder drainage; Endoscopic ultrasound-guided; Cholecystenterostomy; Cholecystogastrostomy; Cholecystoduodenostomy; Percutaneous cholecystostomy; Endoscopic transpapillary gallbladder drainage; Acute cholecystitis