Endoscopic Ultrasound-Guided Gallbladder Drainage in an Elderly Patient

OBJECTIVE
In this video report, the use and clinical outcomes of endoscopic ultrasound-guided gallbladder drainage are aimed to be presented.

CASE
A 95-year-old patient with a history of hypertension and coronary artery disease presented with abdominal pain and fever. Physical examination revealed tenderness in the right upper quadrant and a positive Murphy’s sign. General surgery was consulted, surgery was evaluated as high risk due to the patient’s age and comorbid diseases, and endoscopic intervention was planned after consultation with the patient and his relatives. The patient’s cholestasis tests were found to be high, and ultrasonography and Magnetic resonance (MR)/Magnetic resonance cholangiopancreatography (MRCP) revealed dilated intrahepatic and extrahepatic bile ducts, gallbladder stones, and findings consistent with calculous cholecystitis. The patient underwent Endoscopic Retrograde Cholangiopancreatography (ERCP), and the stones in the common bile duct were expelled into the intestine with a stone balloon, and then a Hot Spaxus metal stent was placed from the bulb to the gallbladder under the guidance of endosonography and the procedure was completed. An endoscopic ultrasound-guided gallbladder drainage procedure was performed.

METHODS
Visual
The endoscopic ultrasound-guided drainage procedure was successfully completed. In this video, drainage of gallstones and sludge from the gallbladder into the duodenal lumen through the HOT SPAXUS™ stent placed in the gallbladder in the first segment of the duodenum under sonography guidance is seen (Video 1). A control endoscopic examination was performed a week later, and it was observed that the stent was in place and functioning. The baby scope was used to pass through the stent into the gallbladder (Video 2). Written informed consent was obtained from patients who participated in this study.

RESULTS
Post procedure, the patient showed significant improvement in symptoms. Follow-up confirmed the effectiveness of the drainage. In conclusion, endoscopic ultrasound-guided gallbladder drainage is a minimally invasive and effective treatment option, particularly for elderly patients with comorbidities.

Cite this article as: Gençdal G, Akyıldız M. Endoscopic ultrasound-guided gallbladder drainage in an elderly patient. Diagn Interv Endosc.2024;3(3):50.