2019 Volume 33 Issue 1 Pages 12-21
Endoscopic retrograde cholangiopancreatography (ERCP) is the mainstay of endoscopic diagnosis and treatment of biliary tract diseases but recently endoscopic ultrasound (EUS) including intraductal ultrasound (IDUS) plays an important role in clinical practice. The diagnostic yield of EUS for bile duct stones is superior to CT and MRI. IDUS is utilized in the diagnosis of cholangiocarcinoma and EUS-FNA is increasingly reported for pathological diagnosis of biliary tract diseases. EUS-guided biliary drainage (EUS-BD) was first reported in cases with failed or difficult ERCP but recent clinical trials demonstrated similar efficacy of EUS-BD and transpapillary drainage by ERCP in the management of malignant biliary obstruction as a first line treatment. Development of dedicated devices is warranted for further spread of EUS-BD in clinical practice.
