Published online Feb 16, 2019. doi: 10.4253/wjge.v11.i2.103
Peer-review started: December 21, 2019
First decision: January 6, 2019
Revised: January 23, 2019
Accepted: February 13, 2019
Article in press: February 13, 2019
Published online: February 16, 2019
Over the last decade, endoscopic ultrasound-guided biliary drainage (EUS-BD) has evolved into a widely accepted alternative to the percutaneous approach in cases of biliary obstruction with failed endoscopic retrograde cholangiopancreaticography (ERCP). The available evidence suggests that, in experienced hands, EUS-BD might even replace ERCP as the first-line procedure in specific situations such as malignant distal bile duct obstruction. The aim of this review is to summarize the available data on EUS-BD and propose an evidence-based algorithm clarifies the role of the different EUS-BD techniques in the management of benign and malignant biliary obstructive disease.
Core tip: Endoscopic ultrasound-guided biliary drainage (EUS-BD) has recently been introduced as a valuable approach case in patients with failed endoscopic retrograde cholangiopancreaticography (ERCP). Evidence suggests that EUS-BD is equally effective and safer than the percutaneous approach. EUS-BD has even been proposed as a first-line procedure (replacing ERCP) in selected indications. Various approaches for EUS-BD exist, depending on the type (malignant or benign) and location (distal or proximal) of the biliary obstruction, and the anatomy of the upper gastrointestinal tract (surgically altered or not). This review gives an overview of the technique and the available data of EUS-BD in several indications.