Recent advances in endoscopic ultrasound‐guided biliary drainage

Abstract

Endoscopic ultrasound-guided biliary drainage (EUS-BD) is increasingly used as an alternative in patients with biliary obstruction who fail standard endoscopic retrograde cholangiopancreatography (ERCP). The two major endoscopic approach routes for EUS-BD are the transgastric intrahepatic and the transduodenal extrahepatic approaches. Biliary drainage can be achieved by three different methods, transluminal biliary stenting, transpapillary rendezvous technique, and antegrade biliary stenting. Choice of approach route and drainage method depends on individual anatomy, underlying disease, and location of the biliary stricture. Recent meta-analyses have revealed that cumulative technical success and adverse event rates were 90-94% and 16-23%, respectively. Development of new dedicated devices for EUS-BD would help refine the technical aspects and minimize the possibility of complications, making it a more promising procedure.

Analysis of the factors involved in procedural failure: Endoscopic retrograde cholangiopancreatography using a short‐type single‐balloon enteroscope for patients with surgically altered gastrointestinal anatomy

“…Endoscopic ultrasound‐BD is a treatment that has attracted significant attention; however, recent systematic analyses have shown that the high technical success rate of this procedure of 90–94.7% is associated with a high adverse event rate of 16.5–23.3% . As such, adverse events associated with EUS‐BD procedures remain important problems to be resolved.…”

Comparison of the efficacy and safety of endoscopic ultrasound‐guided choledochoduodenostomy and hepaticogastrostomy for malignant distal biliary obstruction: Multicenter, randomized, clinical trial

“…Since its first report in 2001, endoscopic ultrasound‐guided biliary drainage (EUS‐BD) has emerged as a new biliary decompression procedure and has been increasingly used as an effective alternative for biliary obstruction patients with failed ERCP . In the last decade, EUS‐BD has been attracting considerable attention and various endoscopic techniques have been described for its implementation . Among these, EUS‐BD with transmural stenting can be carried out by two main access routes: choledochoduodenostomy (CDS) and hepaticogastrostomy (HGS).…”

Clinical efficacy and safety of endoscopic ultrasound‐guided gallbladder drainage replacement of percutaneous drainage: A multicenter retrospective study

“…In recent years, much attention has been paid to a novel indwelling drainage technique under endoscopic ultrasound (EUS) guidance . EUS‐guided gallbladder drainage (EUS‐GBD) has been proposed as an alternative to PTGBD in patients with cholecystitis who cannot undergo cholecystectomy.…”