2025 Volume 39 Issue 5 Pages 769-776
Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) has emerged as a valuable treatment option for patients with acute cholecystitis who are at high surgical risk. Compared to percutaneous (PTGBD) and transpapillary (ETGBD) drainage, EUS-GBD has demonstrated advantages in terms of pain relief, recurrence rates, and adverse events. The introduction of lumen-apposing metal stents (LAMS) has significantly improved technical success and safety. The indication is basically for cases deemed "never surgery," and while its application as preoperative drainage is being explored in some instances, it has been reported to increase the difficulty of laparoscopic cholecystectomy due to the effects of fistula formation, fibrosis, and adhesions, thereby raising the risk of conversion to open surgery. Proficiency in this procedure requires adequate experience and training, and it should be performed in specialized centers. In aging societies such as Japan, the number of candidates is expected to rise. However, strict adherence to current indications and appropriate institutional support are essential to ensure safe and effective implementation.
