Post written by Anthony Yuen Bun Teoh, FRCSEd (Gen), from the Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong SAR.

EUS-guided gallbladder drainage (EUS-GBD) is a safe alternative to percutaneous cholecystostomy (PT-GBD) for acute cholecystitis. How the procedure compares to laparoscopic cholecystectomy (LC) is uncertain. The aim of the current study is to compare the outcomes of EUS-GBD with LC for acute cholecystitis using propensity score analysis.

EUS-GBD was shown to be associated with reduced adverse events, shorter hospital stays, fewer reinterventions and also unplanned readmissions as compared to PT-GBD. The gallbladder could also be cleared of gallstones endoscopically by interventions through the stent placed during EUS-GBD. It would be interesting to know if EUS-GBD compares favorably to the gold standard of treatment, laparoscopic cholecystectomy.

The outcomes of EUS-GBD for acute cholecystitis were comparable to LC with acceptable rates of recurrent acute cholecystitis. The results provide some initial data in support of EUS-GBD as an alternative to LC in a selected group of surgically fit patients.

We are now performing a prospective study looking at the long-term outcomes of EUS-GBD in surgically fit patients instead of laparoscopic cholecystectomy for acute cholecystitis. The outcomes would provide more data on longevity of this modality.

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