Abstract
Purpose of Review
Diseases of the gallbladder can be increasingly managed through endoscopic interventions, either serving as an alternative to or obviating the need for cholecystectomy. In this review, we aim to review the most recent data on endoscopic management of the most common gallbladder diseases.
Recent Findings
The development of lumen-opposing metal stents (LAMS) marked a major shift in gallbladder management, with transmural techniques now well studied for management of cholecystitis. Endoscopic ultrasound (EUS) is also a well-developed technique for gallbladder imaging, comparable or superior to transabdominal ultrasound. Novel techniques with LAMS for gallbladder lesion/polyp resection and treatment of non-cholecystitis gallbladder diseases mark important milestones in gallbladder preservation and increasingly less invasive management of diseases of the gallbladder.
Summary
There are multiple interventional endoscopic techniques that can be used to manage common gallbladder diseases including cholecystitis, cholelithiasis, gallbladder lesions/polyps, and gallbladder cancer. Ongoing development of novel therapeutic techniques holds promise for additional minimally invasive techniques in the future.
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References
Gallaher JR, Charles A. Acute cholecystitis: a review. JAMA. 2022;327(10):965–75.
Teoh AYB, Leung CH, Tam PTH, Au Yeung KKY, Mok RCY, Chan DL, et al. EUS-guided gallbladder drainage versus laparoscopic cholecystectomy for acute cholecystitis: a propensity score analysis with 1-year follow-up data. Gastrointest Endosc. 2021;93(3):577–83. Emerging data that EUS-GBD is comparable in outcomes and adverse events to laparoscopic cholecystectomy for patients with acute cholecystitis.
Irani SS, Sharma NR, Storm AC, Shah RJ, Chahal P, Willingham FF et al. EUS-guided Transluminal Gallbladder Drainage in Patients with Acute Cholecystitis: A Prospective Multicenter Trial. Ann Surg. 2022.
Siddiqui A, Kunda R, Tyberg A, Arain MA, Noor A, Mumtaz T, et al. Three-way comparative study of endoscopic ultrasound-guided transmural gallbladder drainage using lumen-apposing metal stents versus endoscopic transpapillary drainage versus percutaneous cholecystostomy for gallbladder drainage in high-risk surgical patients with acute cholecystitis: clinical outcomes and success in an International, Multicenter Study. Surg Endosc. 2019;33(4):1260–70.
Yuste RT, García-Alonso FJ, Sánchez-Ocana R, Cimavilla M, Herrero IP, Carbajo AY, et al. Safety and clinical outcomes of endoscopic ultrasound-guided gallbladder drainage with lumen-apposing metal stents in patients with dwell time over one year. Ann Gastroenterol. 2019;32(5):514–21.
Oh D, Song TJ, Cho DH, Park DH, Seo D-W, Lee SK, et al. EUS-guided cholecystostomy versus endoscopic transpapillary cholecystostomy for acute cholecystitis in high-risk surgical patients. Gastrointest Endosc. 2019;89(2):289–98.
**Teoh AYB, Kitano M, Itoi T, Pérez-Miranda M, Ogura T, Chan SM et al. Endosonography-guided gallbladder drainage versus percutaneous cholecystostomy in very high-risk surgical patients with acute cholecystitis: an international randomised multicentre controlled superiority trial (DRAC 1). Gut. 2020;69(6):1085–1091. Randomized trial demonstrating EUS-GBD is superior to percutaneous cholecystostomy in regards to adverse events, need for re-intervention, and recurrence of cholecystitis.
Teoh AYB, Serna C, Penas I, Chong CCN, Perez-Miranda M, Ng EKW, et al. Endoscopic ultrasound-guided gallbladder drainage reduces adverse events compared with percutaneous cholecystostomy in patients who are unfit for cholecystectomy. Endoscopy. 2017;49(2):130–8.
Saumoy M, Tyberg A, Brown E, Eachempati SR, Lieberman M, Afaneh C et al. Successful cholecystectomy after endoscopic ultrasound gallbladder drainage compared with percutaneous cholecystostomy, can it be done? J Clin Gastroenterol. 2018.
James TW, Krafft M, Croglio M, Nasr J, Baron T. EUS-guided gallbladder drainage in patients with cirrhosis: results of a multicenter retrospective study. Endosc Int Open. 2019;7(9):E1099–104.
Ge N, Sun S, Sun S, Wang S, Liu X, Wang G. Endoscopic ultrasound-assisted transmural cholecystoduodenostomy or cholecystogastrostomy as a bridge for per-oral cholecystoscopy therapy using double-flanged fully covered metal stent. BMC Gastroenterol. 2016;16:9.
Larghi A, Rimbas M, Attili F, Kunda R. Endoscopic holmium laser lithotripsy of symptomatic gallstones through a Lumen-Apposing Self-Expandable Metal Stent. Am J Gastroenterol. 2016;111(11):1516.
Flynn DJ, Memel Z, Hernandez-Barco Y, Visrodia KH, Casey BW, Krishnan K. Outcomes of EUS-guided transluminal gallbladder drainage in patients without cholecystitis. Endosc Ultrasound. 2021;10(5):381–6.
Szpakowski J-L, Tucker L-Y. Outcomes of Gallbladder Polyps and their Association with Gallbladder Cancer in a 20-Year cohort. JAMA Netw Open. 2020;3(5):e205143.
Sugiyama, Atomi. Yamato. Endoscopic ultrasonography for diVerential diagnosis of polypoid gall bladder lesions: analysis in surgical and follow up series.
Kim SY, Cho JH, Kim EJ, Chung DH, Kim KK, Park YH, et al. The efficacy of real-time colour doppler flow imaging on endoscopic ultrasonography for differential diagnosis between neoplastic and non-neoplastic gallbladder polyps. Eur Radiol. 2018;28(5):1994–2002.
Singla V, Agarwal R, Anikhindi SA, Puri P, Kumar M, Ranjan P, et al. Role of EUS-FNA for gallbladder mass lesions with biliary obstruction: a large single-center experience. Endosc Int Open. 2019;7(11):E1403–9.
Kang SH, Joo JS, Kim SH, Kim KH, Lee ES. EUS-guided fine-needle biopsy of gallbladder polypoid lesions. VideoGIE. 2020;5(4):151–3.
Shen Y, Cao J, Zhou X, Zhang S, Li J, Xu G, et al. Endoscopic ultrasound-guided cholecystostomy for resection of gallbladder polyps with lumen-apposing metal stent. Medicine. 2020;99(43):e22903. First description of LAMS use for gallbladder polyp resection.
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J.H reviewed the literature, drafted the manuscript, and reviewed the manuscript. T.B. reviewed the literature and critically reviewed the manuscript.
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No funding was received to assist with the preparation of this manuscriptTodd H. Baron has served as a consultant for the following relevant organizations: Boston Scientific, Cook Endoscopy, ConMed, W.L. Gore, Olympus, Medtronic.
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Hudson, J.L., Baron, T.H. Endoscopic Management of Gallbladder Disease. Curr Gastroenterol Rep 25, 250–254 (2023). https://doi.org/10.1007/s11894-023-00886-5
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DOI: https://doi.org/10.1007/s11894-023-00886-5