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World J Gastrointest Endosc. May 16, 2019; 11(5): 354-364
Published online May 16, 2019. doi: 10.4253/wjge.v11.i5.354
Comprehensive review on EUS-guided biliary drainage
Raffaele Salerno, Sophia Elizabeth Campbell Davies, Nicolò Mezzina, Sandro Ardizzone
Raffaele Salerno, Nicolò Mezzina, Sandro Ardizzone, Gastroenterology and Digestive Endoscopy Unit, ASST Fatebenefratelli Sacco - Department of Biochemical and Clinical Sciences “L. Sacco”, University of Milan, Milano 20100, Italy
Sophia Elizabeth Campbell Davies, Hospital Pharmacy, ASST Fatebenefratelli Sacco, Piazza Principessa Clotilde, Milan 20121, Italy
Author contributions: All authors contributed equally to this manuscript.
Conflict-of-interest statement: All authors have no conflicts of interest to report.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Raffaele Salerno, MD, Doctor, Gastroenterology and Digestive Endoscopy Unit, ASST Fatebenefratelli Sacco - Department of Biochemical and Clinical Sciences “L. Sacco”, University of Milan, Corso Porta Nuova 23, Milan 20100, Italy. raffaele.salerno@asst-fbf-sacco.it
Telephone: +39-33-97817266 Fax: +39-02-63632249
Received: March 15, 2019
Peer-review started: March 15, 2019
First decision: April 11, 2019
Revised: April 21, 2019
Accepted: May 1, 2019
Article in press: May 1, 2019
Published online: May 16, 2019
Abstract

Feasibility of endoscopic retrograde cholangiopancreatography (ERCP) for biliary drainage is not always applicable due to anatomical alterations or to inability to access the papilla. Percutaneous transhepatic biliary drainage has always been considered the only alternative for this indication. However, endoscopic ultrasonography-guided biliary drainage represents a valid option to replace percutaneous transhepatic biliary drainage when ERCP fails. According to the access site to the biliary tree, two kinds of approaches may be described: the intrahepatic and the extrahepatic. Endoscopic ultrasonography-guided rendez-vous transpapillary drainage is performed where the second portion of the duodenum is easily reached but conventional ERCP fails. The recent introduction of self-expandable metal stents and lumen-apposing metal stents has improved this field. However, the role of the latter is still controversial. Echoendoscopic transmural biliary drainage can be challenging with potential severe adverse events. Therefore, trained endoscopists, in both ERCP and endoscopic ultrasonography are needed with surgical and radiological backup.

Keywords: Endoscopic ultrasonography-guided biliary drainage, EUS, Percutaneous transhepatic biliary drainage, Endoscopic ultrasonography-guided hepatogastric anastomosis, Endoscopic ultrasonography-guided antegrade stent placement, Endoscopic ultrasonography-guided choledochoduodenostomy, Endoscopic ultrasonography-guided transgallbladder, Endoscopic ultrasonography-guided rendezvous

Core tip: Feasibility of endoscopic retrograde cholangiopancreatography for biliary drainage is not always applicable due to anatomical alterations or to inability to access the papilla. Percutaneous transhepatic biliary drainage has always been considered the only alternative for this indication. Endoscopic ultrasonography-guided biliary drainage represents a valid option to replace the other two methods.