EUS-guided gallbladder drainage is a viable option for high-risk patients with acute cholecystitis, offering both safety and effectiveness.

• Technical and clinical success rates were high at 95.8%.
• The study analyzed data from 701 patients across 18 studies with over a year of follow-up.

Surgeons can consider EUS-GBD as a first-line treatment for patients unfit for surgery, given its low adverse event rates.

• This approach offers a durable solution with minimal complications.