Therapeutic Endoscopy to the Rescue: EUS Gallbladder Drainage and ESD of a Giant Duodenal Polyp.

The role of endoscopy in the management of traditionally surgical conditions continues to evolve. Endoscopic techniques, including endoscopic mucosal resection and more recently endoscopic submucosal dissection, which remove cancerous and precancerous lesions in the gastrointestinal tract, continue to grow in use. In addition, therapeutic endoscopic ultrasound has evolved to include the management of patients with acute cholecystitis. Here, we present an 83-year-old man with acute calculus cholecystitis, who was considered ineligible for cholecystectomy and had a giant duodenal polyp that obstructed the visualization of the duodenal lumen, preventing the successful placement of lumen-apposing metal stents. Volume reduction of a duodenal polyp was performed through epinephrine injection to assist in the successful endoscopic ultrasound-guided gallbladder drainage. Subsequently, the patient underwent elective endoscopic mucosal resection to remove the giant duodenal polyp.