Endoscopic ultrasound-guided gallbladder drainage is now more effective than traditional methods for patients unfit for surgery.

• EUS-guided drainage shows higher technical success rates and better patient outcomes compared to percutaneous methods.
• Fewer complications and reinterventions are reported with EUS compared to previous techniques.

Surgeons should consider EUS for optimal patient selection in non-surgical candidates, balancing drainage effectiveness with long-term considerations.

• Individualized approaches in multidisciplinary teams are essential for managing complex cases.