EUS-guided Biliary Drainage -Recent Advances-

Abstract

EUS-guided biliary drainage (EUS-BD) has been increasingly used as an alternative in patients with biliary obstruction in whom standard ERCP failed. Its potential and efficacy has drawn attention and many articles about EUS-BD have been published in the past few years. Various endoscopic approaches have been described for EUS-BD. There are two major approach routes; transgastric intrahepatic approach and transduodenal extrahepatic approach. Biliary drainage may be achieved by three different methods; transmural biliary stenting, transpapillary rendezvous maneuver, and antegrade biliary stenting. The choice of drainage route and method depends on the individual anatomy and location of the biliary stricture. A recent systematic review and meta-analysis that included 42 studies with 1192 patients who underwent EUS-BD revealed that the cumulative technical success rate and the adverse event rate were 94.7% and 23.3%, respectively. The development of a new dedicated device for EUS-BD would help to refine the technical aspects and minimize the possibility of complications, making it a more sophisticated and promising procedure.