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Updated: Dec 20, 2025
Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
EUS-guided biliary drainage in patients with distal malignant biliary obstruction requires fewer interventions and
Félix I Téllez-Ávila1, Mónica Auxiliadora Figueredo-Zacarías2, Everardo Muñoz-Anaya2
1Department of Gastrointestinal Endoscopy, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Vasco de Quiroga #15. Tlalpan, CP 14000, Mexico, Mexico. felixtelleza@gmail.com.
Introduction:
Endoscopic retrograde cholangiopancreatography (ERCP) biliary drainage is considered the reference standard in patients with biliary obstruction, but it is not free of complications. EUS-guided biliary drainage (EUS-BD) is considered an alternative in patients with failed ERCP; however, data are scarce as to whether EUS-BD could be considered a first option.
Objective:
The aim of our study was to compare the need for reintervention and cost between ERCP biliary drainage vs. EUS-BD.
Material And Methods:
We conducted a retrospective and comparative study of patients with distal malignant biliary obstruction with biliary drainage with ERCP + plastic stent (ERCP-PS) vs. ERCP + metal stent (ERCP-MS) vs. EUS-BD.
Results:
124 patients were included, divided into three groups: ERCP-PS, 60 (48.3%) patients; ERCP-MS, 40 (32.2%) patients; and EUS-BD, 24 (19.3%) patients. The need for reinterventions (67 vs. 37 vs. 4%, respectively), the number of procedures [3 (1-10) vs. 2 (1-7) vs. 1 (1-2)], and the costs (4550 ± 3130 vs. 5555 ± 3210 vs. 2375 ± 1020 USD) were lower in the EUS-BD group. No differences in terms of complications were detected.
Conclusion:
EUS-BD requires fewer reinterventions and has a lower cost compared to drainage by ERCP with metal or plastic stents.
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