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Cholecystectomy following EUS-guided gallbladder drainage in patients with acute cholecystitis at high surgical risk: friend or foe?
  1. Alberto Larghi1,
  2. Roy L J van Wanrooij2,
  3. Michiel Bronswijk3,
  4. Giuseppe Vanella4,
  5. Rastislav Kunda1,
  6. Manuel Pérez-Miranda5,
  7. Jeanin E Van-Hooft6,
  8. Marc A Barthet7,
  9. Paolo Giorgio Arcidiacono4,
  10. Schalk Willem Van der Merwe8
  1. 1Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
  2. 2Gastroenterology and Hepatology, Amsterdam UMC, Locatie VUmc, Amsterdam, Noord-Holland, The Netherlands
  3. 3Gastroenterology-Hepatology, Department of Gastroenterology and Hepatology, Imelda General Hospital, Belgium, Bonheiden, Belgium
  4. 4Pancreatobiliary Endoscopy and Endosonography Division, IRCCS San Raffaele Scientific Institute, Milan, Italy
  5. 5Gastroenterology and Hepatology, University Hospital Rio Hortega, Valladolid, Spain
  6. 6Gastroenterology & Hepatology, Leiden University Medical Centre, Leiden, The Netherlands
  7. 7Gastroenterology, Hopital Nord, Marseille Cedex 20, France
  8. 8CHROMETA, KU Leuven, Leuven, Belgium
  1. Correspondence to Dr Alberto Larghi, Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy; alberto.larghi{at}yahoo.it

https://doi.org/10.1136/gutjnl-2024-332273

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    We read with great interest the paper by Bang et al,1 reporting their single-centre retrospective experience in 25 patients with acute cholecystitis, who were deemed at increased surgical risk and treated by EUS-guided gallbladder drainage (EUS-GBD) using LAMS. Three patients underwent surgery because of persistent biliary-type symptoms, but the presence of LAMS precluded successful laparoscopic cholecystectomy (LC) and open or subtotal cholecystectomy was required. Diverging from the recent guidelines of the European Society of Gastrointestinal Endoscopy and the American Gastroenterological Association,2 3 the authors concluded that EUS-GBD should only be considered in patients for whom surgery would never be an option. We thank Bang et al, for sharing their experience with these unfortunate surgical outcomes, which encourages further discussion on how to use this technique. However, some of the points raised in their study deserve …

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    Footnotes

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    • Contributors Study concept and design and drafting of the manuscript: AL. Revision of the manuscript for important intellectual content: all authors. Approval of the final manuscript: all the authors. Guarantor of the article: AL.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.