Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Jan;37(1):93-102.
doi: 10.1111/den.14946. Epub 2024 Nov 18.

Endoscopic ultrasound-guided gallbladder drainage for acute cholecystitis

Jacquelyn Chi Ying Fok  1 , Anthony Yuen Bun Teoh  1   2 , Shannon Melissa Chan  1
Affiliations
Review

Endoscopic ultrasound-guided gallbladder drainage for acute cholecystitis

Jacquelyn Chi Ying Fok et al. Dig Endosc. 2025 Jan.

Abstract

With technological advances in endoscopic ultrasonography, endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) was introduced as a treatment option for acute cholecystitis. Recently, new studies have emerged, suggesting that EUS-GBD has a lower adverse event rate and reintervention rate, when compared to percutaneous drainage and endoscopic transpapillary gallbladder drainage. There is growing interest in the different technical aspects of EUS-GBD, such as the puncture approach, choice of stents, and long-term management. There are also cohorts on performing EUS-GBD in potential surgical candidates. This review article gathers the latest evidence on EUS-GBD, including its indications, procedural techniques, choice of equipment, outcomes, postprocedural care, and the controversial extended indications.

Keywords: EUS‐guided gallbladder drainage; acute cholecystitis; laparoscopic cholecystectomy; percutaneous cholecystostomy.

PubMed Disclaimer

Conflict of interest statement

Author Dr. Anthony Y.B. Teoh is an Associate Editor of Digestive Endoscopy. He is also a consultant for CMR Surgical, Boston Scientific, Cook, Taewoong, Microtech, and MI Tech Medical Corporations. The other authors declare no conflict of interests for this article.

Figures

Figure 1
Figure 1
Endoscopic ultrasound view of a moderately distended gallbladder. A 19G needle was used to puncture the gallbladder. In gallbladders that are not so distended, a needle puncture approach is recommended because the gallbladder can be further distended with normal saline and insertion of guidewire can ensure a safer deployment.
Figure 2
Figure 2
A 0.025 guidewire was inserted into the gallbladder via the 19G needle, and looped in the gallbladder.
Figure 3
Figure 3
Endoscopic ultrasound‐guided deployment of distal flange.
Figure 4
Figure 4
Deployment of proximal flange in the lumen with pus oozing out.
Figure 5
Figure 5
Fluoroscopic picture showing the lumen apposing metal stent in satisfactory position with a 8.5F 3 cm double‐pigtail within.
See this image and copyright information in PMC

References

    1. Mori Y, Itoi T, Baron TH et al. Tokyo guidelines 2018: Management strategies for gallbladder drainage in patients with acute cholecystitis (with videos). J Hepatobiliary Pancreat Sci 2018; 25: 87–95. - PubMed
    1. Okamoto K, Suzuki K, Takada T et al. Tokyo guidelines 2018: Flowchart for the management of acute cholecystitis. J Hepatobiliary Pancreat Sci 2018; 25: 55–72. - PubMed
    1. Kwan V, Eisendrath P, Antaki F, Le Moine O, Deviere J. EUS‐guided cholecystenterostomy: A new technique (with videos). Gastrointest Endosc 2007; 66: 582–586. - PubMed
    1. Jang JW, Lee SS, Song TJ et al. Endoscopic ultrasound‐guided transmural and percutaneous transhepatic gallbladder drainage are comparable for acute cholecystitis. Gastroenterology 2012; 142: 805–811. - PubMed
    1. Lee SS, Park DH, Hwang CY et al. EUS‐guided transmural cholecystostomy as rescue management for acute cholecystitis in elderly or high‐risk patients: A prospective feasibility study. Gastrointest Endosc 2007; 66: 1008–1012. - PubMed

MeSH terms

LinkOut - more resources