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Review
. 2024 Dec 3:17:17562848241299755.
doi: 10.1177/17562848241299755. eCollection 2024.

A review of endoscopic ultrasound-guided gallbladder drainage and gastroenterostomy: assisted approaches and comparison with alternative techniques

Rongmin Xu  1 , Kai Zhang  1 , Jintao Guo  1 , Siyu Sun  2
Affiliations
Review

A review of endoscopic ultrasound-guided gallbladder drainage and gastroenterostomy: assisted approaches and comparison with alternative techniques

Rongmin Xu et al. Therap Adv Gastroenterol. .

Abstract

Over the last 40 years, the role of endoscopic ultrasound (EUS) has evolved from being diagnostic to therapeutic. EUS-guided gallbladder drainage (EUS-GBD) and EUS-guided gastroenterostomy (EUS-GE) are emerging techniques in recent years; however, there are limited studies and inconsistent results regarding these techniques. In addition, EUS has become a more common alternative to traditional interventions due to its super minimally invasive nature, but the mobility of both the gallbladder and intestine makes it challenging to introduce stents. An increasing number of researchers are dedicating themselves to solving this problem, leading to the development of various assisted technologies. Consequently, this review focused on the comparison of EUS-GBD and EUS-GE with other alternative approaches and explored the various assisted techniques employed for EUS-GBD and EUS-GE.

Keywords: EUS-GBD; EUS-GE; PT-GBD; endoscopic enteral stenting; laparoscopic cholecystectomy; peroral cholecystoscopy.

Plain language summary

Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) and endoscopic ultrasound-guided gastroenterostomy (EUS-GE) have emerged as novel, minimally invasive endoscopic interventional techniques in recent years, have become the increasingly popular alternative to conventional surgical and percutaneous interventions. However, the superiority of endoscopic ultrasound-guided interventional therapy remains controversial topics in the medical literature. Additionally, the mobility of gallbladder and intestine reduces technical success rate. Therefore, this article comprehensively compares EUS-GBD, EUS-GE and other alternative methods, as well as the assisted methods of them.

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Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Steps of EUS-GBD. (a) EUS imaging reveals a dilated gallbladder filled with sludge and exhibiting thickened walls, indicative of acute cholecystitis. (b) EUS-guided fine-needle aspiration of the gallbladder is shown. (c) A fluoroscopic image illustrates the contrast filling the gallbladder. (d) Balloon dilation (red star) of the LAMS (red arrow). (e) The distal flange (green arrow) is deployed under EUS guidance. (f) Endoscopic imaging follows the successful transgastric placement of the LAMS into the gallbladder. Source: Reproduced with permission from Luk et al. CC BY Copyright 2023 Nicholas J Koutlas. EUS, endoscopic ultrasound; EUS-GBD, EUS-guided gallbladder drainage; LAMS, lumen-apposing metal stent.
Figure 2.
Figure 2.
WEST of EUS-GE. (a) The proximal jejunal limb is dilated by the oroenteric catheter. The hyperechogenic spots are the contrast. (b) A free-hand gastrojejunal perforation is made using the catheter of the LAMS. (c) Deployment of the distal flange of the LAMS under EUS control. (d) Endoscopic view of the proximal flange of the LAMS completely deployed. Source: Reproduced with permission from Perez-Cuadrado-Robles et al. CC BY Copyright 2022 Enrique Perez-Cuadrado-Robles. EUS, endoscopic ultrasound; EUS-GE, EUS-guided gastroenterostomy; LAMS, lumen-apposing metal stent; WEST, wireless endoscopic simplified technique.
Figure 3.
Figure 3.
Part of assisted EUS-GE techniques. (a) Balloon-assisted dilation. (b) EPASS. Source: Reproduced with permission from Tonozuka et al. CC BY 3.0. Copyright 2020 Ryosuke Tonozuka. EPASS, EUS-guided double-balloon-occluded gastroenterostomy bypass; EUS, endoscopic ultrasound; EUS-GE, EUS-guided gastroenterostomy.
See this image and copyright information in PMC

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