EUS-guided gallbladder drainage versus laparoscopic cholecystectomy for acute cholecystitis

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.

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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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Read the full article online.

The information presented in Endoscopedia reflects the opinions of the authors and does not represent the position of the American Society for Gastrointestinal Endoscopy (ASGE). ASGE expressly disclaims any warranties or guarantees, expressed or implied, and is not liable for damages of any kind in connection with the material, information, or procedures set forth.

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