title: International collaborative study on EUS-guided gallbladder drainage: Are we ready for prime time?
abstract: BACKGROUND
  Cholecystectomy remains the gold standard treatment of cholecystitis. Endoscopic treatment of cholecystitis includes transpapillary gallbladder drainage. Recently, endoscopic ultrasound-guided transmural drainage of the gallbladder (EUS-GBD) has been reported. This study reports the cumulative experience of an international group performing EUS-GBD.
  
  
  METHODS
  Cases of EUS-GBD from January 2012 to November 2013 from 3 tertiary-care institutions were captured in a registry. Patient demographics, disease characteristics, procedural and clinical outcomes were recorded.
  
  
  RESULTS
  35 patients (15 malignant, 20 benign) were included. Median age was 81 years (SD=13.76 years), sixteen (46%) were males. Median follow-up was 91.5 days (SD=157 days). Transmural access was obtained from the stomach (n=17) or duodenum (n=18). Stents placed included plastic (n=6), metal (n=20), or combination (n=7). Technical success was achieved in 91.4% (n=32). Immediate adverse events (14%) included: bleeding, stent migration, cholecystitis and hemoperitoneum. Delayed adverse events (11%) included abscess formation and recurrence of cholecystitis. Long-term clinical success rate was 89%. Stent type and puncture site were not associated with immediate (p=0.88, p=0.62), or long-term (p=0.47, p=0.27) success.
  
  
  CONCLUSIONS
  EUS-GBD appears to be feasible, safe, and effective. Prospective studies are needed to confirm these findings and identify the best technique to use.
  
  
  BACKGROUND
  NCT01522573.
authors.affiliation: Division of Gastroenterology and Hepatology, Weill Cornell Medical College, New York, NY, United States. Electronic address: mkahaleh@gmail.com.
authors.forename: Michel
authors.initials: M
authors.lastname: Kahaleh
authors.affiliation: Hospital del Rio Hortega, Rio Hortega, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Perez-Miranda
authors.affiliation: University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Everson L
authors.initials: EL
authors.lastname: Artifon
authors.affiliation: Division of Gastroenterology and Hepatology, Weill Cornell Medical College, New York, NY, United States.
authors.forename: Reem Z
authors.initials: RZ
authors.lastname: Sharaiha
authors.affiliation: Division of Gastroenterology and Hepatology, Weill Cornell Medical College, New York, NY, United States.
authors.forename: Prashant
authors.initials: P
authors.lastname: Kedia
authors.affiliation: Hospital del Rio Hortega, Rio Hortega, Spain.
authors.forename: Irene
authors.initials: I
authors.lastname: Peñas
authors.affiliation: Hospital del Rio Hortega, Rio Hortega, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: De la Serna
authors.affiliation: Division of Gastroenterology and Hepatology, Weill Cornell Medical College, New York, NY, United States.
authors.forename: Nikhil A
authors.initials: NA
authors.lastname: Kumta
authors.affiliation: University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Fernando
authors.initials: F
authors.lastname: Marson
authors.affiliation: Division of Gastroenterology and Hepatology, Weill Cornell Medical College, New York, NY, United States.
authors.forename: Monica
authors.initials: M
authors.lastname: Gaidhane
authors.affiliation: Staten Island University Hospital, Staten Island, NY, United States.
authors.forename: Christine
authors.initials: C
authors.lastname: Boumitri
authors.affiliation: Division of Gastroenterology and Hepatology, Weill Cornell Medical College, New York, NY, United States.
authors.forename: Viviana
authors.initials: V
authors.lastname: Parra
authors.affiliation: Division of Gastroenterology and Hepatology, Weill Cornell Medical College, New York, NY, United States.
authors.forename: Carlos M
authors.initials: CM
authors.lastname: Rondon Clavo
authors.affiliation: Institute Paoli-Calmettes, Marseille, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Giovannini
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002763:Cholecystectomy / Q000592:standards; D041881:Cholecystitis, Acute / Q000601:surgery*; D004322:Drainage / Q000009:adverse effects / Q000379:methods*; D019160:Endosonography / Q000379:methods*; D005260:Female; D005704:Gallbladder / Q000000981:diagnostic imaging*; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D012008:Recurrence; D012189:Retrospective Studies; D015607:Stents
keywords: Cholecytitis; EUS; EUS-GBD; Endoscopic gallbladder drainage; Endoscopic ultrasound; Gallbladder drainage