We thank the authors for their interest in our report on endoscopic ultrasound-guided gallbladder drainage (EUS-GBD).1 Management of gallbladder disease is not within the sole domain of gastroenterologists. It includes surgeons and interventional radiologists. When guidelines are developed without multidisciplinary consensus, problems can occur as reported in our series.2 The distinction between never-surgery and high-risk surgical patients is more than semantics. The former includes patients with end-stage lung disease such as pulmonary hypertension, irreversible severe vascular disease, end-stage cardiac disease in non-transplant patients, active inoperable malignancy and liver cirrhosis with portal hypertension. Performing EUS-GBD in this patient cohort is a no-brainer. In others, multidisciplinary consensus is critical.3 The multicentre case-control (1:2 match between EUS and percutaneous cohorts) study cited by authors in defence of EUS is retrospective, underpowered and does not stratify for disease severity.4 In …

中文翻译：

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EUS引导下胆囊引流治疗急性胆囊炎：对致编辑信的回应

我们感谢作者对我们关于超声内镜引导胆囊引流 (EUS-GBD) 的报告的兴趣。1 胆囊疾病的治疗不属于胃肠病学家的专属领域。它包括外科医生和介入放射科医生。当在没有多学科共识的情况下制定指南时，可能会出现我们系列中报道的问题。2从未进行过手术和高风险手术患者之间的区别不仅仅是语义上的。前者包括肺动脉高压等终末期肺部疾病患者、不可逆的严重血管疾病、非移植患者的终末期心脏病、活动性不能手术的恶性肿瘤以及伴有门静脉高压的肝硬化患者。在该患者队列中进行 EUS-GBD 是理所当然的。在其他情况下，多学科共识至关重要。3 作者在为 EUS 辩护时引用的多中心病例对照（EUS 与经皮队列之间 1:2 匹配）研究是回顾性的、动力不足且未对疾病严重程度进行分层。4 在……