[Endoscopic ultrasound-guided choledochoduodenostomy for relieving malignant distal biliary obstruction]

Ultrasound-guided biliary drainage is a new and effective method for relieving obstructive lesions of the biliary tract. In the hands of experienced operators, ultrasound-guided diversion of the mid portion of the common bile duct and the duodenal bulb is a feasible strategy for the relief of jaundice secondary to distal obstruction (distal bile duct tumors, pancreatic head cancer, or major duodenal papillary tumor), with low morbidity and mortality rates. The technical aspects of the procedure and its indications are reviewed herein, emphasizing its performance in institutions equipped with experienced personnel adhering to strict study protocols.