Mar 19, 2015

Endoscopic ultrasound-guided biliary drainage: a review

Current Treatment Options in Gastroenterology
Shannon Melissa Chan, Anthony Y B Teoh

Abstract

Endoscopic retrograde cholangiography (ERCP) has become the standard tool for diagnosis and treatment of patients with biliary obstruction. However, despite the reported success rate of >90 % in expert centers, the common bile duct may still be occasionally inaccessible due to anatomical or technical issues. Over the past decade, endoscopic ultrasound-guided biliary drainage (EUS-BD) has emerged as an effective alternative over percutaneous transhepatic biliary drainage (PTBD) or surgical bypass for biliary drainage after unsuccessful ERCP. EUS-BD includes rendezvous techniques (EUS-RV), EUS-guided choledochoduodenostomy (EUS-CDS), and EUS-guided hepatogastrostomy (EUS-HGS). Published data demonstrated high success rates especially for EUS-CDS and EUS-HGS. Complication rates, however, are also higher in these two techniques. The indications and anatomical requirements for the three techniques differ and should be considered complementary to each other. Most reported studies only included a small number of patients, and larger-scaled randomized trials are required to establish the efficacy among various EUS techniques and to compare to traditional means of radiological or surgical drainage.

  • References57
  • Citations3

Citations

Mentioned in this Paper

Health Center
Surgical Drainage (Treatment) (General)
Study
perfluoro-2,2,2',2'-tetramethyl-4,4'-bis(1,3-dioxolane)
Choledochoduodenostomy
Anatomic Structures
Clinical Trials, Randomized
Bipolar Disorder
Endoscopic Ultrasound
Complication

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