Endoscopic therapies for gallbladder drainage,Gastrointestinal Endoscopy

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Endoscopic therapies for gallbladder drainage
Gastrointestinal Endoscopy ( IF 6.7 ) Pub Date : 2021-07-31 , DOI: 10.1016/j.gie.2021.05.031
Monica Saumoy ₁ , Julie Yang ₂ , Amit Bhatt ₃ , Juan Carlos Bucobo ₄ , Vinay Chandrasekhara ₅ , Andrew P Copland ₆ , Kumar Krishnan ₇ , Nikhil A Kumta ₈ , Ryan J Law ₅ , Rahul Pannala ₉ , Mansour A Parsi ₁₀ , Erik F Rahimi ₁₁ , Guru Trikudanathan ₁₂ , Arvind J Trindade ₁₃ , David R Lichtenstein ₁₄

Affiliation

Department of Gastroenterology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Division of Gastroenterology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
Department of Gastroenterology, Hepatology & Nutrition, Cleveland Clinic, Cleveland, Ohio, USA.
Division of Gastroenterology and Hepatology, Stony Brook Medicine, Stony Brook, New York, USA.
Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
Division of Gastroenterology and Hepatology, University of Virginia Health Systems, Charlottesville, Virginia, USA.
Division of Gastroenterology, Department of Internal Medicine, Harvard Medical School and Massachusetts General Hospital, Boston, Massachusetts, USA.
Division of Gastroenterology, Mount Sinai Hospital, New York, New York, USA.
Department of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, Arizona, USA.
Section for Gastroenterology and Hepatology, Tulane University Health Sciences Center, New Orleans, Louisiana, USA.
Department of Gastroenterology, Baylor Scott & White Health, Lakeway, Texas, USA.
Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, Minnesota, USA.
Department of Gastroenterology, Zucker School of Medicine at Hofstra/Northwell, Long Island Jewish Medical Center, New Hyde Park, New York, USA.
Division of Gastroenterology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA.

Background and Aims

Endoscopic management of acute cholecystitis has expanded in patients who are considered nonoperative candidates. Traditionally managed with percutaneous cholecystostomy (PC), improvement in techniques and devices has led to increased use of endoscopic methods for gallbladder drainage. This document reviews technical aspects of endoscopic transpapillary gallbladder drainage (ET-GBD) and EUS-guided GBD (EUS-GBD) as well as their respective technical/clinical success and adverse event rates. Available comparative data are also reviewed among nonsurgical gallbladder drainage techniques (PC, ET-GBD, and EUS-GBD).

Methods

The MEDLINE database was searched through March 2021 for relevant articles by using keywords including “acute cholecystitis,” “interventional EUS,” “percutaneous cholecystostomy,” “transpapillary gallbladder drainage,” “EUS-guided gallbladder drainage,” “lumen-apposing metal stent,” “gallbladder stenting,” and “endoscopic gallbladder drainage.” The manuscript was drafted by 2 authors and reviewed by members of the American Society for Gastrointestinal Endoscopy Technology Committee and subsequently by the American Society for Gastrointestinal Endoscopy Governing Board.

Results

Multiple studies have demonstrated acceptable outcomes comparing PC and both endoscopic gallbladder drainage techniques, ET-GBD and EUS-GBD. Published data suggest that endoscopic gallbladder drainage techniques may be associated with lower rates of adverse events and improved quality of life. However, there are important clinical considerations for choosing among these treatment options, requiring a multidisciplinary and collaborative approach to therapeutic decision-making in these patients.

Conclusions

The implementation of EUS-GBD and ET-GBD in high-risk surgical patients with acute cholecystitis may result in favorable outcomes when compared with PC. Further improvements in techniques and training should lead to more widespread acceptance and dissemination of these treatment options.

中文翻译：

胆囊引流的内镜治疗

背景和目标

急性胆囊炎的内镜治疗在被认为是非手术候选者的患者中得到了扩展。传统上通过经皮胆囊造口术 (PC) 进行管理，技术和设备的改进导致更多地使用内窥镜方法进行胆囊引流。本文件回顾了内窥镜经乳头状胆囊引流 (ET-GBD) 和 EUS 引导的 GBD (EUS-GBD) 的技术方面以及它们各自的技术/临床成功率和不良事件发生率。还审查了非手术胆囊引流技术（PC、ET-GBD 和 EUS-GBD）的可用比较数据。

方法

使用“急性胆囊炎”、“介入性 EUS”、“经皮胆囊造口术”、“经乳头状胆囊引流术”、“EUS 引导的胆囊引流术”、“腔内金属支架”等关键词在 MEDLINE 数据库中搜索到 2021 年 3 月的相关文章、“胆囊支架置入术”和“内窥镜胆囊引流术”。该手稿由 2 位作者起草，并由美国胃肠内窥镜学会技术委员会成员审阅，随后由美国胃肠内窥镜学会管理委员会审阅。