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

1.1 Endoscopic ultrasound-guided gallbladder drainage for acute cholecystitis can be used when surgery is not an option, if standard arrangements are in place for clinical governance, consent and audit. Find out what standard arrangements mean on the NICE interventional procedures guidance page.

1.2 For auditing the outcomes of this procedure, the main efficacy and safety outcomes identified in this guidance can be entered into NICE's interventional procedure outcomes audit tool (for use at local discretion).

1.3 This technically challenging procedure should only be done in specialist centres by clinicians trained and experienced in using this procedure for gallbladder drainage.

Why the committee made these recommendations

Standard treatment for acute cholecystitis is keyhole (laparoscopic) or open surgery to remove the gallbladder (cholecystectomy). But for some people, surgery is too risky, or they may not be able to have it because they have other conditions that make surgery unsuitable.

There is good evidence to show that this procedure is effective in treating acute cholecystitis and is an alternative when surgery is not an option. A disadvantage of this procedure, when compared with cholecystectomy, is that cholecystitis may reoccur.