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Endoscopic ultrasound (EUS)–guided biliary drainage continues to slowly enter mainstream practice. Endoscopic retrograde cholangiopancreatography (ERCP) remains the gold-standard approach to achieving relief from biliary obstruction. However, in some patients with malignancy, most commonly pancreatic cancer, ERCP is either technically unsuccessful or cannot be performed (e.g., in the case of gastric outlet obstruction where the ampulla cannot be physically reached). In these instances, EUS-guided approaches to biliary access and drainage are often performed.
In a recent meta-analysis, researchers compared ERCP and EUS approaches to biliary drainage in the setting of malignant biliary obstruction. The final analysis included data from 5 studi…