NICE includes endoscopic ultrasound guided gall bladder drainage as option to treat acute cholecystitis

July 3, 2023

Updated guidance from the National Institute for Health and Care Excellence (NICE) in the UK has confirmed that when surgery is not an option, endoscopic ultrasound guided gall bladder drainage (EUS-GBD) can be used to treat inflamed gall bladders^[1]. The condition, which is known as acute cholecystitis, is caused by gallstones blocking the ducts that drain the gall bladder. Bile is unable to drain from the gallbladder leading to pain, nausea, vomiting and fever. NICE provides evidenced-based guidance to improve health and social care in the National Health Service (NHS) in the UK.

NICE reviewed the evidence on the safety and efficacy of EUS-GBD, which included the Boston Scientific Hot Axios™ Stent and Electrocautery-Enhanced Delivery System. NICE concluded that EUS-GBD can be used provided that standard arrangements are in place for clinical governance, consent, and auditing. NICE is satisfied with the evidence of safety and efficacy so that doctors may now offer this minimally invasive procedure to patients.

“In the UK, acute cholecystitis occurs in 10–15% of people reporting symptomatic gallstones which leaves them experiencing pain, nausea, vomiting and fever,^[2]” said Astrid Monteau, vice president of Endoscopy in Europe, Middle East and Africa. “Healthcare professionals in the UK have another treatment option to cholecystostomy to improve the quality of patients’ lives under the latest guidance from NICE. They undergo comprehensive training to deliver endoscopic ultrasound guided gall bladder drainage in collaboration with a specialist multidisciplinary team.”

Women are three times more likely than men to experience acute cholecystitis up to the age of 50 years, according to the British Medical Journal. After 50, the condition is 1.5 times more common in women than in men^[3].

Hot Axios is an endoscopic device designed to enable the ultrasound-trained interventional endoscopist to deliver a stent between the gastrointestinal tract and a pancreatic pseudocyst, gallbladder, or bile duct, to drain fluid from selected organs. Hot Axios is available in Hepato-pancreato-biliary centres, at locations including London, Leeds, and Nottingham.