Endoscopic alternatives for patients with acute cholecystitis

In patients with acute cholecystitis who are deemed high risk for cholecystectomy, percutaneous cholecystostomy (PT-GBD) was commonly performed for gallbladder drainage. Recently, EUS-guided gallbladder drainage (EUS-GBD) has gained attention as another potential treatment method by internally draining the gallbladder and removing gallstones. The study “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)” compared the outcomes of these treatments in high-risk patients suffering from acute cholecystitis in a randomized controlled trial. Compared with PT-GBD, EUS-GBD improved outcomes of those high-risk patients such as reducing adverse events and re-interventions. This modality is supported to be a definite treatment but further studies are required to determine its long-term efficacy. (Gut. 2020 Mar 12. pii: gutjnl-2019-319996. doi: 10.1136/gutjnl-2019-319996. [Epub ahead of print])

Anyone interested in future collaboration in this field of research is welcome to contact our key investigator Prof Anthony TEOH in the Department of Surgery, CUHK. Prof Teoh’s research focuses on robotics and minimal invasive surgery for upper gastrointestinal cancers, endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography.