Percutaneous tranhepatic gallbladder drainage (PTGBD) is considered a safe alternative to early cholecystectomy, especially in surgically high - risk patients with acute cholecystitis. Although randomized prospective controlled trial are lacking, data from most retrospective studies demonstrate that PTGB is the most common gallbladder drainage method. There are several alternatives to PTGBD. Percutaneous tranhepatic gallbladder aspiration is simple alternative drainage method with fewer complications: however, in clinical usefulness has been shown only by case - series studies. Endoscopic naso - gallbladder drainage and gallbladder stenting via a transpapillary endoscopic approach are also alternative methods in acute cholecystitis, but both of them have technical difficulties resulting in lower success rates than that of PTGBD. Recently, endoscopic untrasonography - guided transmusal gallbladder drainage has been reported as a special technique for gallbladder drainage. However, it is not yet an established technique. Therefore, it should be perfomed in high - volume institutes by skilled endoscopists. Further prospective evaluations of the feasibility, satety, and efficacy of these various approaches are needed. This article decribes indications and techniques of drainage for acute cholecystitis.
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