Endoscopic ultrasound-guided gallbladder drainage for acute cholecystitis when surgery is not an option

NICE did a rapid review of the published literature on the efficacy and safety of this procedure. This comprised a comprehensive literature search and detailed review of the evidence from 12 sources, which was discussed by the committee. The evidence included 4 systematic reviews, 1 randomised controlled trial, 3 non-randomised comparative studies, 1 registry, 1 case series and 2 case reports. It is presented in the summary of key evidence section in the overview. Other relevant literature is in the appendix of the overview.

The professional experts and the committee considered the key efficacy outcomes to be: effective drainage of the gallbladder, resolution of sepsis, and symptom relief, including reduction in pain and improvement in quality of life.

The professional experts and the committee considered the key safety outcomes to be: pain, infection, damage to adjacent structures, bile leak and need for further intervention.

Two commentaries from people who have had this procedure were discussed by the committee.

The committee was informed that people may need post-procedure follow up and this may involve more than 1 specialty.

The committee was informed that clinicians who wish to do this procedure need a period of training in endoscopic ultrasound-guided techniques for other procedures.