title: EUS-guided transmural cholecystostomy as rescue management for acute cholecystitis in elderly or high-risk patients: a prospective feasibility study.
abstract: 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.
authors.affiliation: Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
authors.forename: Sang Soo
authors.initials: SS
authors.lastname: Lee
authors.forename: Do Hyun
authors.initials: DH
authors.lastname: Park
authors.forename: Chang Yun
authors.initials: CY
authors.lastname: Hwang
authors.forename: Chul-Soo
authors.initials: CS
authors.lastname: Ahn
authors.forename: Tae Yoon
authors.initials: TY
authors.lastname: Lee
authors.forename: Dong-Wan
authors.initials: DW
authors.lastname: Seo
authors.forename: Sung Koo
authors.initials: SK
authors.lastname: Lee
authors.forename: Myung-Whan
authors.initials: MW
authors.lastname: Kim
mesh_terms: 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