Endoscopic Ultrasound-Guided Gallbladder Drainage With Lumen-Apposing Metal Stents in Comparison to Percutaneous Cholecystostomy for the Non-Surgical Management of Acute Cholecystitis: Systematic Review and Meta-Analysis

Abstract

Gallstone disease is a widespread medical condition that is associated with high morbidity rates, and often requires surgical intervention (Schirmer, Winters and Edlich). The standard treatment of acute cholecystitis, inflammation of the gallbladder, is laparoscopic cholecystectomy whereby the gallbladder is removed in a mildly invasive surgical procedure. For individuals who are unable to undergo surgery, percutaneous transhepatic drainage of the gallbladder is an alternative option for resolution of cholecystitis. More recently, endoscopic management of acute cholecystitis, such as drainage with metal stents, has emerged as a novel approach that is minimally invasive and associated with a low risk of complications. The objective of this systematic review and meta-analysis is to compare the overall efficacy and safety of endoscopic guided gallbladder (EUS-GB) drainage using all marketed Lumen Apposing Metal Stents (LAMS) with that of percutaneous transhepatic cholecystostomy (PC) in patients that are unable to undergo surgery for treatment of acute cholecystitis.