Gut Liver.  2013 Mar;7(2):129-136.

Advances in Endoscopic Ultrasound-Guided Biliary Drainage: A Comprehensive Review

• Sarkaria S
• Lee HS
• Gaidhane M
• Kahaleh M

Abstract

Endoscopic retrograde cholangiopancreatography (ERCP) has become the first-line therapy for bile duct drainage. In the hands of experienced endoscopists, conventional ERCP results in a failed cannulation rate of 3% to 5%. This failure can occur more commonly in the setting of altered anatomy or technically difficult cases due to either duodenal or biliary obstruction. In cases of ERCP failure, patients have traditionally been referred for either percutaneous transhepatic biliary drainage (PTBD) or surgery. However, both PTBD and surgery have higher than desirable complication rates. Within the last decade, endoscopic ultrasound-guided biliary drainage (EUS-BD) has become an attractive alternative to PTBD after failed ERCP. Many groups have reported on the feasibility, efficacy and safety of this technique. This article reviews the indications for ERCP and the currently practiced EUS-BD techniques, including EUS-guided rendezvous, EUS-guided choledochoduodenostomy and EUS-guided hepaticogastrostomy.

Keyword

Endoscopic retrograde cholangiopancreatography; Endoscopic ultrasound; Self expanding metal stent

MeSH Terms

Bile Ducts
Catheterization
Cholangiopancreatography, Endoscopic Retrograde
Choledochostomy
Dioxolanes
Drainage
Fluorocarbons
Hand
Humans
Dioxolanes
Fluorocarbons