Published online Jan 21, 2015. doi: 10.3748/wjg.v21.i3.726
Peer-review started: February 21, 2014
First decision: March 13, 2014
Revised: April 29, 2014
Accepted: June 21, 2014
Article in press: June 23, 2014
Published online: January 21, 2015
Endoscopic retrograde cholangiopancreatography (ERCP) is the preferred procedure for biliary and pancreatic drainage. While ERCP is successful in about 95% of cases, a small subset of cases are unsuccessful due to altered anatomy, peri-ampullary pathology, or malignant obstruction. Endoscopic ultrasound-guided drainage is a promising technique for biliary, pancreatic and recently gallbladder decompression, which provides multiple advantages over percutaneous or surgical biliary drainage. Multiple retrospective and some prospective studies have shown endoscopic ultrasound-guided drainage to be safe and effective. Based on the currently reported literature, regardless of the approach, the cumulative success rate is 84%-93% with an overall complication rate of 16%-35%. endoscopic ultrasound-guided drainage seems a viable therapeutic modality for failed conventional drainage when performed by highly skilled advanced endoscopists at tertiary centers with expertise in both echo-endoscopy and therapeutic endoscopy
Core tip: This summary of the endoscopic ultrasound (EUS)-guided biliary drainage consortium held in 2012 focuses on technical improvements in both EUS-Guided biliary and pancreatic drainage techniques. This summary also provides a detailed overview of EUS-guided choledochoduodenostomy compared to percutaneous transhepatic cholangiography and surgical drainage. Other EUS Guided techniques such as endoscopic ultrasound-guided pancreatico-gastrostomy and endoscopic ultrasonography-guided cholecystoduodenostomy and cholecystogastrostomy have been discussed. Lastly, an extensive review of therapeutic endoscopic interventions in surgically altered anatomy has been provided as well.