We read with great interest the paper by Bang et al,1 reporting their single-centre retrospective experience in 25 patients with acute cholecystitis, who were deemed at increased surgical risk and treated by EUS-guided gallbladder drainage (EUS-GBD) using LAMS. Three patients underwent surgery because of persistent biliary-type symptoms, but the presence of LAMS precluded successful laparoscopic cholecystectomy (LC) and open or subtotal cholecystectomy was required. Diverging from the recent guidelines of the European Society of Gastrointestinal Endoscopy and the American Gastroenterological Association,2 3 the authors concluded that EUS-GBD should only be considered in patients for whom surgery would never be an option. We thank Bang et al, for sharing their experience with these unfortunate surgical outcomes, which encourages further discussion on how to use this technique. However, some of the points raised in their study deserve …