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Updated: May 25, 2026
Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
EUS-guided biliary drainage: a review article
Everson L A Artifon1, Flávio Coelho Ferreira, José Pinhata Otoch
1University of São Paulo Medical School, São Paulo, Brazil. eartifon@hotmail.com
Context:
To demonstrate a comprehensive review of published articles regarding EUS-guided biliary drainage.
Methods:
Review of studies regarding EUS-guided biliary drainage including case reports, case series and previous reviews.
Results:
EUS-guided hepaticogastrostomy, choledochoduodenostomy and choledochoantrostomy are advanced procedures on biliary and pancreatic endoscopy and together make up the echo-guided biliary drainage. Hepaticogastrostomy is indicated in cases of hilar obstruction, while the procedure of choice is choledochoduodenostomy in distal lesions. Both procedures must be done only after unsuccessful ERCP. The indication of these procedures must be made under a multidisciplinary view while sharing information with the patient or legal guardian.
Conclusion:
Hepaticogastrostomy and choledochoduodenostomy are feasible when performed by endoscopists with expertise in biliopancreatic endoscopy and advanced echo-endoscopy and should be performed currently under rigorous protocol in educational institutions.
