EUS-guided transmural cholecystostomy as rescue management for acute cholecystitis in elderly or high-risk patients: a prospective feasibility study.
BACKGROUND
Although EUS-guided drainage procedures have been used to collect peripancreatic fluids, little is known regarding EUS-guided transmural gallbladder drainage for high-risk patients with acute cholecystitis.


OBJECTIVE
Our purpose was to evaluate the technical feasibility and outcomes of EUS-guided transmural cholecystostomy as rescue management in elderly and high-risk patients with acute cholecystitis.


METHODS
Single-center prospective study.


METHODS
Tertiary referral center.


METHODS
Nine elderly or high-risk patients diagnosed with acute cholecystitis.


METHODS
All inflamed gallbladders were drained by EUS-guided transmural cholecystostomy.


METHODS
Clinical resolution of acute cholecystitis.


RESULTS
After the drainage procedures, there were no immediate complications such as bleeding, bile leak, or peritonitis, except for 1 patient who had pneumoperitoneum. After EUS-guided transmural cholecystostomy, all patients showed rapid clinical improvement within 72 hours.


CONCLUSIONS
Small number of patients.


CONCLUSIONS
EUS-guided transmural cholecystostomy may be feasible and safe as initial, interim, or even definitive treatment of patients with severe acute cholecystitis who are at high operative risk for immediate cholecystectomy.
Lee
Sang Soo
SS
Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
Park
Do Hyun
DH
Hwang
Chang Yun
CY
Ahn
Chul-Soo
CS
Lee
Tae Yoon
TY
Seo
Dong-Wan
DW
Lee
Sung Koo
SK
Kim
Myung-Whan
MW
D000368:Aged; D000369:Aged, 80 and over; D041881:Cholecystitis, Acute / Q000628:therapy*; D002767:Cholecystostomy / Q000379:methods*; D004322:Drainage; D019160:Endosonography / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome