Biliary Drainage with Endoscopic Ultrasound Guidance

Two studies show that EUS-guided drainage is feasible, but many questions about the procedure still need to be answered.

When a patient’s anatomy precludes endoscopic retrograde cholangiopancreatography (ERCP) or when ERCP is unsuccessful, percutaneous or surgical procedures are used to drain the bile duct. However, both techniques are more invasive, are associated with higher morbidity, and produce more discomfort than does ERCP. Because the left hepatic ducts are visualized easily by endoscopic ultrasound (EUS), a transluminal approach to the left biliary system is possible. Two research groups in Europe assessed EUS-guided biliary drainage as an alternative to percutaneous or surgical approaches in patients with ERCP failures.

In one study, eight patients with malignant biliary strictures and three patients with benign biliary strictures underwent transgast…

Reviewing Author

Stuart Sherman, MD