Nasogallbladder Drainage: Endoscopic Alternative for Severe Acute Cholecystitis

Abstract

Acute cholecystitis is mainly caused by the obstruction of the cystic duct or the gallbladder neck by stones. The usual management is emergency or urgent cholecystectomy, depending on the severity of the disease. In patients at high surgical risk, gallbladder drainage is chosen, which is traditionally approached percutaneosly or with endoscopic methods through the placement of nasobiliary tubes, transpapillary stents or transmural stents by endoscopic ultrasound. The endoscopic approach has the advantage of maintaining the integrity of the skin barrier, is less painful and has less impact on the patient’s quality of life. Two clinical cases of endoscopic drainage are presented: that of a young woman with acute cholecystitis and septic shock in the context of severe burns, and that of an elderly man with similar clinical deterioration, both of whom underwent endoscopic drainage with placement of a nasogallbladder tube, with good clinical response and subsequent surgical resolution.