Oral Poster

Aim: Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) is an emerging alternative to percutaneous cholecystostomy (PTC) in achieving gallbladder drainage in patients with acute cholecystitis who are unfit for cholecystectomy.This retrospective cohort study aims to compare the safety, efficacy and durability of these two procedures.Method: This single-center retrospective cohort study evaluated patients with high surgical risk treated for acute cholecystitis with either EUS-GBD or PTC at Princess Margaret Hospital between July 2022 and June 2025.The primary outcome was the 1-year cumulative adverse event rate.Secondary outcomes included technical success, clinical success, post-intervention length of stay (LOS), 1-year unplanned readmission rate, and 1year recurrent cholecystitis rate.Results: A total of 224 patients were analyzed (EUS-GBD: n = 72; PTC: n = 152).EUS-GBD demonstrated a significantly lower 1-year cumulative adverse event rate compared to PTC (16.7% [13/72] vs. 70.4% [107/152], p < 0.0001).Patients undergoing EUS-GBD also experienced significantly shorter postintervention LOS and fewer 1-year unplanned readmissions (16.7% [12/72] vs. 39.5% [60/152], p = 0.0006).No statistically significant differences were observed between EUS-GBD and PTC regarding technical success (98.7% [71/72] vs. 96.0%[146/152], p = 0.4338), clinical success (90.3% [65/72] vs. 82.2%[125/152], p = 0.0824), or 1-year recurrent cholecystitis rate (4.2% [3/72] vs. 5.9% [9/152], p = 0.7558).Conclusion: EUS-GBD reduces 1-year adverse events, readmissions, and hospital length of stay compared to PTC, while maintaining comparable technical and clinical success rates in high-risk patients with acute cholecystitis.