Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) is a safe and effective option for nonoperative candidates with symptomatic cholelithiasis without cholecystitis.

• Complete gallstone clearance achieved in 100% of patients; 87% cleared in one treatment.
• All 23 patients had technical success with LAMS placement, and no procedure-related adverse events occurred.
• No symptom recurrence noted over a mean follow-up of 9 months.

Consider EUS-GBD for managing gallstones in patients unfit for surgery.