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Related Concept Videos

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Related Experiment Video

Updated: Nov 27, 2025

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
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Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction

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Advances in Biliary Access.

Abdul H El Chafic1, Janak N Shah2

  • 1Department of Gastroenterology, Ochsner Health - New Orleans, 1514 Jefferson Hwy, New Orleans, LA, 70121, USA.

Current Gastroenterology Reports
|December 5, 2020
PubMed
Summary
This summary is machine-generated.

Endoscopic ultrasound (EUS)-guided interventions show greater success for biliary access compared to conventional endoscopic retrograde cholangiopancreatography (ERCP) techniques, offering a promising alternative for challenging cases.

Keywords:
Bile duct cannulationBiliary accessBiliary drainageEndoscopic retrograde cholangiopancreatography (ERCP)Endoscopic ultrasound (EUS)

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Area of Science:

  • Gastroenterology
  • Interventional Endoscopy
  • Medical Imaging

Background:

  • Conventional endoscopic retrograde cholangiopancreatography (ERCP) techniques have limitations, with biliary access failure in up to 16% of procedures.
  • Advanced methods, including ERCP-based maneuvers and endoscopic ultrasound (EUS)-guided interventions, have emerged to overcome these challenges.

Purpose of the Study:

  • To review the evidence supporting various ERCP and EUS techniques for achieving biliary access.
  • To compare the efficacy and outcomes of different ERCP and EUS-guided biliary access strategies.

Main Methods:

  • Systematic review of existing literature on ERCP and EUS techniques for biliary access.
  • Analysis of comparative studies evaluating EUS-guided interventions versus conventional ERCP methods.
  • Examination of randomized trials comparing EUS and ERCP for biliary drainage in malignant obstructions.

Main Results:

  • EUS-rendezvous demonstrated higher success rates for biliary access compared to precut papillotomy after failed conventional cannulation.
  • EUS-guided drainage showed favorable clinical success, safety, and cost-efficiency compared to percutaneous drainage.
  • Recent trials indicate similar success rates for EUS and ERCP in drainage for malignant obstructions.
  • EUS-guided techniques generally outperform ERCP-based methods for biliary access and drainage.

Conclusions:

  • EUS-guided interventions represent a significant advancement for biliary access and drainage, often surpassing conventional ERCP techniques.
  • Emerging technologies in interventional EUS are poised to further refine and improve treatment approaches for biliary interventions.