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Cholecystectomy is the gold standard in the treatment of acute cholecystitis, but has a significantly increased risk in multimorbid patients or in the severe course of acute cholecystitis. In such cases, drainage of the damaged gallbladder in combination with antibiotic therapy may be superior to primary surgery. The drainage can either be performed as sonographically guided percutaneous transhepatic gallbladder drainage or as EUS-guided transmural stent placement or endoscopic-transpapillary gallbladder drainage. These minimally invasive alternatives to cholecystectomy can be used both as long-term therapy for permanently inoperable patients and temporarily for patients in whom the cholecystectomy is intended after improvement of the general condition. In this overview, the various drainage methods are discussed with regard to technical requirements, immediate and long-term clinical results and complications. With advances in stent design, EUS-guided transmural stent placement from the stomach or duodenum into the gallbladder is becoming the preferred method of gallbladder drainage in centers with the appropriate expertise.

Original publication

DOI

10.1055/a-1540-8019

Type

Journal article

Journal

Zeitschrift fur Gastroenterologie

Publication Date

09/2021

Volume

59

Pages

983 - 990

Addresses

Abteilung für Gastroenterologie und Hepatologie, München Klinik Neuperlach und Harlaching, München, Germany.

Keywords

Humans, Cholecystitis, Acute, Endosonography, Endoscopy, Treatment Outcome, Drainage, Stents