Standardising minimally invasive management in surgically unfit patients requiring cholecystectomy: Overview of current recommendations and future directions

Table 2 Efficacy and safety of endoscopic gallbladder drainage

Ref.	Study population	Results/recommendation
Itoi et al[28], 2015	RCT; ENGBD (n = 37) by 5F or 7F tube; ET-GBD (n = 36) by 7F stent	Similar technical and clinical success, adverse event is higher in ENGBD group than ET-GBD (2 vs 1)
Sobani et al[29], 2021	Retrospective study; (n = 21); dual stenting	Second stent placed simultaneously or after an interval. The median interval between the placement of the first and the second stents was 37 days. Technical and clinical success rates were 100% with adverse events in 9.2%
Jandura and Puli[30], 2021	Meta analysis. 21 studies, 1307 patients	The pooled technical success rate was (82.62%), and the clinical success rate (94.87%). The pooled overall complication rate was 8.83% (bleeding 1.03%, perforation 0.78%, peritonitis/bile leak 0.45% and pancreatitis 1.98%). The pooled rates of stent occlusion and migration were 0.39% and 1.3%, respectively. The pooled recurrence rate of cholecystitis following ET-GBD was 1.48%
Ridtitid et al[31], 2024	RCT. ET-GBD (n = 60); only antibiotic (n = 60)	ET-GBD has a significantly lower rate of recurrent cholecystitis compared to the no ET-GBD group; most recurrences occurred within 3 months of acute cholecystitis
Haddad et al[32], 2025	Multicentre retrospective study. Single vs double stent (59 vs 16)	Overall technical and clinical success 88.2% and 81.3%, respectively. Unplanned reintervention was lower in the double-stenting group (0.5% vs 25.4%)
Nakahara et al[33], 2025	Retrospective study ET-GBD for gangrenous acute cholecystitis. GC (n = 29) and non-GC (n = 62)	The technical success rate, clinical success rate for acute cholecystitis, and rate of early adverse events are similar in both GC and non-GC groups [86.2% vs 91.9% (P = 0.63), 79.3% vs 91.9% (P = 0.17), and 27.6% vs 16.1% (P = 0.32)]
Amin et al[34], 2025	Multicenter retrospective. ET-GBD (n = 73); dual 7 Fr DPT used EUS-GBD (n = 56)	No significant difference in technical or clinical success. Similar rate of repeat procedure, recurrent cholecystitis in the ET-GBD compared to the EUS-GBD group

RCT: Randomized controlled trial; ENGBD: Endoscopic naso-gallbladder drainage; ET-GBD: Endoscopic trans papillary gallbladder drainage; GC: Gangrenous cholecystitis; DPT: Double pigtail stent; EUS-GBD: Endoscopic ultrasound-guided gallbladder drainage; GBD: Gallbladder drainage.