EUS-GUIDED BILIARY DRAINAGE

Abstract

Endoscopic ultrasound (EUS)-guided biliary drainage (EUS-BD) is a recently described alternative to percutaneous transhepatic biliary drainage (PTBD) for patients in whom endoscopic retrograde cholangiopancreatography (ERCP) has failed. Both EUS-guided choledochoduodenostomy (EUS-CDS) and EUS-guided hepaticogastrostomy (EUS-HGS) are relatively well established as alternatives to PTBD. EUS-BD is a useful procedure, but severe or fatal complications have been reported. When learning EUS-BD, we recommend a mentor’s supervision for a beginner. It is important to instruct beginners about the proper techniques in performing EUS-BD.