Abstract Background EUS guided gallbladder drainage has gradually emerging as an option among patients with cholecystitis. Stent bridged endoscope intervention in the gallbladder was further introduced. The aim of this study was to assess the effectiveness and safety of the ECE-LAMS and this newly designed retrievable puncture anchor applied in the transmural Cholecystolithotomy. Method We retrospectively reviewed consecutive patients undergoing EUS-guided transmural cholecystoscopic therapy. The main outcome measures for the EUS-GBD procedure were techniques success and adverse events, which were also compared between guided assisted group and retrievable anchor assisted group. The main outcome measures for the transmural cholecystoscopy after EUS-GBD were the stent indwelling time, clinical success and adverse events. Results A total of 24 (15 female) patients with gallstones were received the transluminal Cholecystolithotomy. Mean age is 36.08±13.69 years old. The successful rate of the anchor assisted group was high than the guidewire assisted group (92.9% Vs 70%, P=0.07). On the average of 12.25±2.77 (range 8-17) days after the initial BD drainage procedure, 20 patients received the per-oral cholecystoscopy via the fistula. Fistula broken was found in 2 patients in which the per-oral cholecystoscopy was applied on the ninth day after the EUS-GBD. During the follow-up period (mean 314.2± 213.7 days) no GB stones recurrence or other long term complications reported. Conclusion In conclusion, we have demonstrated that EUS-assisted per-oral cholecystoscopy technique with ECE-LMAS is an efficient and safe procedure. For the EUS-GBD procedure, retrievable anchor could significantly increase the success rate compared with the guidewire.