Safety and efficacy of endoscopic ultrasound‐guided gallbladder drainage combined with endoscopic retrograde cholangiopancreatography in the same session

<jats:sec><jats:title>Background and Aim</jats:title><jats:p>Endoscopic ultrasound‐guided gallbladder drainage (EUS‐GBD) is an emerging option for acute cholecystitis in non‐surgical candidates. Combining endoscopic retrograde cholangiopancreatography (ERCP) for common bile duct stones with EUS‐GBD in a single session might become a non‐surgical management strategy to comprehensively treat gallstone disease in selected patients.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Single‐center retrospective cohort study comparing outcomes between EUS‐GBD alone (group A) and single‐session ERCP combined with EUS‐GBD (group B). Consecutive patients who underwent EUS‐GBD with a lumen‐apposing metal stent (LAMS) between June 2011 and August 2018 were analyzed. Exclusion criteria were subjects included in randomized clinical trials, patients who had had ERCP within 5 days of EUS‐GBD, patients in whom ERCP or EUS‐GBD was carried out for salvage of one or the other procedure, and patients who underwent concurrent EUS‐guided biliary drainage.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>One hundred and nine consecutive patients underwent EUS‐GBD with LAMS during the study period. Seventy‐one patients satisfied the inclusion criteria and 34 patients were in group A and 37 in group B. Baseline characteristics were similar in both groups. There were no significant differences in technical (97.1% <jats:italic>vs</jats:italic> 97.3%; <jats:italic>P</jats:italic> = 0.19) and clinical success rates (88.2% <jats:italic>vs</jats:italic> 94.6%; <jats:italic>P</jats:italic> = 0.42) of EUS‐GBD in group A versus group B. Rate of adverse events was similar in both groups, five (14.7%) in group A versus five (13.5%) in group B.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Single‐session EUS‐GBD combined with ERCP has comparable rates of technical and clinical success to EUS‐GBD alone. A combined EUS‐GBD and ERCP procedure does not appear to increase adverse events and makes possible comprehensive treatment of gallstone disease by purely endoscopic means.</jats:p></jats:sec>