Percutaneous, transpapillary, and transmural drainage in acute cholecystitis: a comparative analysis of techniques, stent selection, and clinical

Abstract

Acute cholecystitis is a common inflammatory condition of the gallbladder, primarily caused by gallstone obstruction, leading to increased intraluminal pressure, ischemia, and infection. While laparoscopic cholecystectomy remains the standard treatment, gallbladder drainage techniques have emerged as effective alternatives for high-risk surgical patients. This review explores the indications, techniques, and comparative outcomes of various gallbladder drainage methods, including percutaneous transhepatic gallbladder drainage (PTGBD), endoscopic transpapillary gallbladder drainage (ETGBD), and endoscopic ultrasound-guided gallbladder drainage (EUS-GBD). Endoscopic ultrasound-guided transmural gallbladder drainage, particularly with lumen-apposing metal stents (LAMS), has shown high clinical success rates with fewer complications compared to traditional methods. Advances in stent technology and procedural techniques continue to improve patient outcomes. However, further research is needed to establish long-term efficacy and determine optimal patient selection criteria for different drainage methods. The review highlights the evolving landscape of gallbladder drainage and the need for standardized guidelines to optimize treatment strategies for high-risk patients.

Keywords: acute cholecystitis; clinical outcomes; endoscopic gallbladder drainage; gallbladder drainage.