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World J Gastrointest Endosc. Jul 16, 2012; 4(7): 306-311
Published online Jul 16, 2012. doi: 10.4253/wjge.v4.i7.306
Endoscopic ultrasound guided biliary drainage
Ilaria Tarantino, Luca Barresi, Carlo Fabbri, Mario Traina
Ilaria Tarantino, Luca Barresi, Mario Traina, Unit of Gastroenterology and Digestive Endoscopy, ISMETT Mediterranean Institute for Transplantation and Advanced Specialized Therapies/University of Pittsburgh Medical Center, 54000 Palermo, Italy
Carlo Fabbri, Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna Bellaria-Maggiore Hospital, 40121 Bologna, Italy
Author contributions: Tarantino I wrote the paper; Barresi L, Fabbri C and Traina M critically revised the paper.
Correspondence to: Dr. Ilaria Tarantino, Unit of Gastroenterology and Digestive Endoscopy, ISMETT Mediterranean Institute for Transplantation and Advanced Specialized Therapies/University of Pittsburgh Medical Center, 54000 Palermo, Italy. itarantino@ismett.edu
Telephone: +39-335-7357729 Fax: +39-91-2192400
Received: October 18, 2011
Revised: April 30, 2012
Accepted: July 1, 2012
Published online: July 16, 2012
Abstract

Endoscopic retrograde cholangio-pancreatography is the most appropriate technique for treating common bile duct and pancreatic duct stenosis secondary to benign and malignant diseases. Even if the procedure is performed by skillful endoscopist, there are patients in whom endoscopic stent placement is not possible. Common causes of failure include complex peri-papillary diverticula, prior surgery procedures, tumor involvement of the papilla, biliary sphincter stenosis, and impacted stones. Percutaneous trans-hepatic biliary drainage (PTBD) and surgical intervention carry morbidity and mortality. Recently endoscopic ultrasonography-guided biliary drainage has been reported as an alternative technique. Endoscopic ultrasonography-guided biliary drainage using either direct access or a rendezvous technique has attracted attention as an alternative procedure to PTBD, with a technical success between 75%-100% and with low complication rate. We have reviewed published data on EUS guided biliary drainage procedures with the aim of summarizing the efficacy and safety of this promising method.

Keywords: Interventional endoscopic ultrasonography; Endoscopic ultrasonography drainage; Biliary drainage; Endoscopic retrograde cholangio-pancreatography