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

The optimal method of gallbladder drainage for acute cholecystitis in nonsurgical candidates is uncertain. The aim of the current study was to conduct a network meta-analysis comparing the 3 methods of gallbladder drainage (percutaneous, transpapillary, and EUS-guided).

Currently, there is some evidence suggesting better patient outcomes when the gallbladder is drained endoscopically over percutaneous methods. However, a head-to-head statistical comparison of the 3 methods has not been performed, and the current study fills in the deficit in knowledge.

The 3 modalities of gallbladder drainage have their respective advantages and disadvantages. Selection of the technique will depend on available expertise. In centers with expertise in endoscopic gallbladder drainage, the techniques are preferred over PT-GBD with improved outcomes. 

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