Acute cholecystitis (AC) is the second most common surgical condition of the abdominal organs, particularly prevalent among elderly patients. Cholecystectomy is considered the “gold standard” treatment; however, its performance may be challenging in patients with high surgical risk. As a result, decompressive interventions are playing an increasingly important role, either for temporary relief of symptoms or as an alternative to surgery.
OBJECTIVE
To analyze the scientific literature on modern minimally invasive methods of gallbladder decompression in acute cholecystitis for patients with high surgical risk.
KEY POINTS
Gallbladder decompression can be performed through percutaneous or endoscopic approaches. Percutaneous methods (percutaneous transhepatic puncture and drainage) are less technologically demanding but are accessible and effective for temporary decompression, especially in critically ill patients. The main drawbacks include the risk of post-puncture complications and recurrence of cholecystitis after drain removal. Endoscopic methods (transpapillary and transmural drainage under endoscopic ultrasound guidance) require advanced equipment and specialized expertise. They offer several advantages, including a lower risk of recurrence, but are associated with technical difficulties and potential complications, such as stent migration.
CONCLUSION
Gallbladder decompression is an important alternative for patients with high surgical and anesthetic risk. The choice of method (percutaneous or endoscopic) should be based on equipment availability, specialist expertise, and the patient’s prognosis. Preventing recurrence of cholecystitis and reducing complication rates remain critical aspects of patient management.