Endoscopy 2023; 55(03): 296
DOI: 10.1055/a-1998-4578


Tomas Hucl
1   Department of Gastroenterology and Hepatology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
› Author Affiliations

Endoscopic ultrasound (EUS)-guided drainage has been suggested as the treatment of choice for acute cholecystitis in high risk surgical patients, offering improved outcomes that include fewer re-interventions [1]. Gangrenous cholecystitis is a severe form of cholecystitis typically treated by surgery [2].

In this E-Video, Orlandini et al. report on a case where acute cholecystitis as yet unrecognized as gangrenous was successfully treated by EUS-guided drainage using a 10 × 10-mm lumen-apposing metal stent (LAMS). However, re-intervention was needed 3 weeks later because of stent occlusion by necrotic tissue. The presence of the LAMS allowed for complete endoscopic clearance and long-term recovery.

EUS-guided gallbladder drainage may allow treatment also of gangrenous cholecystitis including subsequent necrosectomy. To avoid the need for re-intervention, the use of larger-caliber stents or coaxial placement of a double-pigtail plastic stent within the metal stent may be considered in these patients [3].

Publication History

Article published online:
28 February 2023

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