Endoscopic Ultrasound–Guided Biliary Drainage: Slowly Gaining Acceptance

Endoscopic ultrasound (EUS)–guided biliary drainage remains an infrequently performed procedure, likely due to a perception of increased risk and the lack of dedicated accessories to perform it. In a recent retrospective cohort study, researchers in Japan evaluated outcomes of EUS-guided biliary drainage in 39 patients with pancreatic cancer who had indwelling duodenal stents. The duodenal stent overlaid the major papilla in 23 patients (59%).

Compared with use of endoscopic retrograde cholangiopancreatography (ERCP) through the duodenal stent, the overall technical success rate with regards to achieving biliary drainage was significantly higher with the EUS-guided approach (95% vs. 56%), as it was for patients in whom the duodenal stent ove…