Eus-Guided Gallbladder Drainage Versus Percutaneous Gallbladder Drainage in Acute Cholecystitis: A Propensity Matched Analysis

Choose the best alternative wisely for biliary interventions after failed ERCP!

“…Koutlas et al applied advanced techniques for EUS-HGS by using fully-covered self-expandable biliary stents. They inserted double pigtail plastic stents through the HGS metal stents to minimize the risk of dislocation and to establish antegrade and retrograde drainage [5]. In contrast, PTCD was performed with conventional techniques, e. g. serial tract dilatation up to 12F and temporary external drainage.…”

“…In this issue of endoscopy, Koutlas et al report on a propensity score matched analysis of a retrospective comparison between EUS-HGS and PTBD after failed ERCP 5 . In a 1:2 ratio, 32 patients undergoing EUS-HG were matched with 64 PTBD cases with no significant differences in patient characteristics.…”

“…These interventions are challenging and may cause severe AE. They cannot fairly be compared with EUS-HG in the current study because EUS-HGS was used almost exclusively (95%) for distal biliary obstruction 5 .…”

“…Benign biliary disorders in 38 patients were mainly related to choledocholithiasis (n = 15) and biliary strictures (n = 23) 5 . EUS-HGS and PTBD were equally effective but the latter was inferior in terms of AEs, procedure duration, number of reinterventions, and hospitalization.…”

“…The authors do not refer to the expertise of the interventionalists. In contrast, they emphasize that all EUS-guided procedures were performed by a single experienced therapeutic endoscopist in a high-volume center 5 .…”