title: Endoscopic Gallbladder Drainage for Acute Cholecystitis.
abstract: OBJECTIVE
  Surgery is the mainstay of treatment for cholecystitis. However, gallbladder stenting (GBS) has shown promise in debilitated or high-risk patients. Endoscopic transpapillary GBS and endoscopic ultrasound-guided GBS (EUS-GBS) have been proposed as safe and effective modalities for gallbladder drainage.
  
  
  METHODS
  Data from patients with cholecystitis were prospectively collected from August 2004 to May 2013 from two United States academic university hospitals and analyzed retrospectively. The following treatment algorithm was adopted. Endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy and cystic duct stenting was initially attempted. If deemed feasible by the endoscopist, EUS-GBS was then pursued.
  
  
  RESULTS
  During the study period, 139 patients underwent endoscopic gallbladder drainage. Among these, drainage was performed in 94 and 45 cases for benign and malignant indications, respectively. Successful endoscopic gallbladder drainage was defined as decompression of the gallbladder without incidence of cholecystitis, and was achieved with ERCP and cystic duct stenting in 117 of 128 cases (91%). Successful endoscopic gallbladder drainage was also achieved with EUS-guided gallbladder drainage using transmural stent placement in 11 of 11 cases (100%). Complications occurred in 11 cases (8%).
  
  
  CONCLUSIONS
  Endoscopic gallbladder drainage techniques are safe and efficacious methods for gallbladder decompression in non-surgical patients with comorbidities.
authors.affiliation: Division of Gastroenterology and Hepatology, Weill Cornell Medical College, Cornell University, New York, NY, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Widmer
authors.affiliation: Division of Gastroenterology and Hepatology, Central University Hospital of Asturias, Asturias, Spain.
authors.forename: Paloma
authors.initials: P
authors.lastname: Alvarez
authors.affiliation: Division of Gastroenterology and Hepatology, Weill Cornell Medical College, Cornell University, New York, NY, USA.
authors.forename: Reem Z
authors.initials: RZ
authors.lastname: Sharaiha
authors.affiliation: Division of Gastroenterology and Hepatology, Weill Cornell Medical College, Cornell University, New York, NY, USA.
authors.forename: Sonia
authors.initials: S
authors.lastname: Gossain
authors.affiliation: Division of Gastroenterology and Hepatology, Weill Cornell Medical College, Cornell University, New York, NY, USA.
authors.forename: Prashant
authors.initials: P
authors.lastname: Kedia
authors.affiliation: Division of Gastroenterology and Hepatology, Weill Cornell Medical College, Cornell University, New York, NY, USA.
authors.forename: Savreet
authors.initials: S
authors.lastname: Sarkaria
authors.affiliation: Digestive and Liver Diseases, Columbia University Medical Center, New York, NY, USA.
authors.forename: Amrita
authors.initials: A
authors.lastname: Sethi
authors.affiliation: Division of Gastroenterology and Hepatology, Weill Cornell Medical College, Cornell University, New York, NY, USA.
authors.forename: Brian G
authors.initials: BG
authors.lastname: Turner
authors.affiliation: Division of Gastroenterology and Hepatology, Weill Cornell Medical College, Cornell University, New York, NY, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Millman
authors.affiliation: Division of Gastroenterology and Hepatology, Weill Cornell Medical College, Cornell University, New York, NY, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Lieberman
authors.affiliation: Division of Gastroenterology and Hepatology, Weill Cornell Medical College, Cornell University, New York, NY, USA.
authors.forename: Govind
authors.initials: G
authors.lastname: Nandakumar
authors.affiliation: Division of Gastroenterology and Hepatology, Weill Cornell Medical College, Cornell University, New York, NY, USA.
authors.forename: Hiren
authors.initials: H
authors.lastname: Umrania
authors.affiliation: Division of Gastroenterology and Hepatology, Weill Cornell Medical College, Cornell University, New York, NY, USA.
authors.forename: Monica
authors.initials: M
authors.lastname: Gaidhane
authors.affiliation: Division of Gastroenterology and Hepatology, Weill Cornell Medical College, Cornell University, New York, NY, USA.
authors.forename: Michel
authors.initials: M
authors.lastname: Kahaleh
keywords: Cholecystitis; Endoscopic ultrasound-guided gallbladder drainage; Fully covered self-expanding metal stent; Metal stent; Transgastric