Observational studySurgical endoscopy2026
Endoscopic ultrasound-guided transmural gallbladder drainage using lumen-apposing metal stents versus percutaneous cholecystostomy for gallbladder drainage in high-risk cirrhosis patients with acute cholecystitis: a multicenter, comparative trial.
Observational study in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimPatients with cirrhosis and acute cholecystitis who are high risk for surgery undergo percutaneous cholecystostomy (PGBD) tube placement. EUS-guided gallbladder drainage (EUS-GB) using lumen-apposing metal stents (LAMS) is a newer intervention. We performed a multicenter cohort study to compare clinical outcomes and adverse events (AEs) of EUS-GB and PGBD in patients with liver cirrhosis who are unfit for surgery.
methodsPatients with cirrhosis and acute cholecystitis who were unfit for surgery underwent gallbladder drainage by EUS-GB or PGBD. Technical success, clinical success, and adverse events were evaluated. Long-term AEs were stratified to biliary tract-related events and catheter-related/device-related AEs. Clinical success was reported on both an intention-to-treat (ITT) basis and a per-protocol basis. Inverse probability-of-treatment-weighted (IPTW) propensity-adjusted models were used to address baseline imbalance.
resultsSixty-three patients with cirrhosis and acute cholecystitis underwent gallbladder drainage: 20 underwent EUS-GB and 43 underwent PGBD. The mean duration of follow-up was 19.9 weeks (range, 1-52). The etiology of the cholecystitis was gallstones (63%) and acalculous (37%). Technical success was achieved in 19/20 (95%) EUS-GB patients and 43/43 (100%) PGBD patients (p = 0.32). Procedure-related AEs were similar between groups (15% vs. 9.3%, p = 0.69). On ITT analysis, clinical success was 19/20 (95%) for EUS-GB and 40/43 (93%) for PGBD (p = 0.99). Long-term biliary tract-related AEs were lower in the EUS-GB group (10.5% vs. 23.3%, p = 0.018). When the secondary device-burden composite was added, the EUS-GB group continued to have significantly fewer long-term events (10.5% vs. 41.9%, p = 0.013). Among the 12 PGBD patients who underwent subsequent cholecystectomy, 7 (58%) were urgent operations driven by drainage failure and 5 (42%) were elective interval cholecystectomies. Surgery was required in a higher proportion of PGBD patients than EUS-GB patients (28% vs. 5%; p = 0.03).
conclusionIn this multicenter retrospective cohort, EUS-GB with LAMS appeared to be an effective and safe alternative to PGBD for cirrhotic patients with acute cholecystitis who cannot undergo surgery, with fewer long-term biliary tract and catheter/device-related events.
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