Safety and adverse events of EUS-guided gallbladder drainage using lumen-apposing metal stents and percutaneous cholecystostomy tubes: a systematic review and meta-analysis

Abstract

Background and AimsEndoscopic ultrasound-guided gallbladder drainage using lumen-apposing metal stent (EUS-GBD-LAMS) and percutaneous cholecystostomy for gallbladder drainage (PTGBD) are the alternative treatment modalities in high-risk surgical patients with acute cholecystitis (AC). Our study aims to compare these procedures’ safety for AC in surgically suboptimal candidates. MethodsSix studies compared the two groups' early, delayed, and overall adverse events, length of hospital stay, re-interventions, and re-admissions rate. A random effect model calculated odds ratios with a 95% confidence interval (CI). ResultsThe two groups had similar early adverse events; however, EUS-GBD-LAMS was associated with a lower rate of delayed (OR: 0.21) [95% CI: 0.07-0.61], p = < 0.01) and overall adverse events (OR: 0.43) [95% CI: 0.30-0.61], p = < 0.01). Patients with EUS-GBD-LAMS had a lower hospital stay than PTGBD. ConclusionsEUS-GBD-LAMS is a safer option than PTGBD and is associated with a shorter hospital stay in non-surgical candidates with AC.