The Evolution of Gallbladder Drainage: From Surgery to Endoscopic Ultrasound-Guided Techniques

Abstract The management of gallbladder disease has evolved from open cholecystectomy to minimally invasive approaches like laparoscopic cholecystectomy and endoscopic ultrasound-guided gallbladder drainage (EUS-GBD). For high-risk surgical candidates, percutaneous transhepatic gallbladder drainage (PT-GBD) has been an alternative option, though it presents limitations such as catheter dislodgement and reduced quality of life. EUS-GBD has emerged as a highly effective solution, offering internal drainage through transmural approaches. The use of lumen-apposing metal stents (LAMS) has further refined the procedure, enhancing safety, technical success, and clinical outcomes. This article provides a historical perspective on gallbladder disease management while highlighting the evolution and clinical impact of EUS-GBD.