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Updated: Jun 22, 2025

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
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EUS-guided versus percutaneous liver abscess drainage: A multicenter collaborative study.

Haroon Shahid1, Amy Tyberg1, Avik Sarkar1

  • 1Gastroenterology, Robert Wood Johnson University Hospital, New Brunswick, NJ.

Endoscopic Ultrasound
|July 1, 2024
PubMed
Summary

Endoscopic ultrasound (EUS)-guided drainage offers a safer and more effective approach for managing hepatic abscesses compared to percutaneous catheter drainage (PCD), leading to faster recovery and fewer complications.

Keywords:
AbscessAbscess drainageEUSLiverpercutaneous drainage

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Area of Science:

  • Gastroenterology
  • Interventional Endoscopy
  • Hepatology

Background:

  • Hepatic abscess management traditionally relies on image-guided percutaneous techniques.
  • Endoscopic ultrasound (EUS)-guided drainage has emerged as a potentially safer and more efficacious alternative.
  • This study directly compares EUS-guided drainage with percutaneous catheter drainage (PCD) for hepatic abscesses.

Purpose of the Study:

  • To compare the efficacy and safety of EUS-guided drainage versus percutaneous catheter drainage (PCD) for hepatic abscesses.
  • To evaluate key outcomes including symptom resolution, hospital stay, adverse events, and procedural requirements.

Main Methods:

  • A registry of patients undergoing EUS-guided drainage or PCD for hepatic abscesses between January 2018 and November 2021 was analyzed.
  • Data collected included demographics, clinical status, abscess characteristics, procedural details, adverse events, and postprocedure care.
  • Seventy-four patients were included (30 EUS-guided, 44 PCD).

Main Results:

  • Technical success was 100% in both groups.
  • EUS-guided drainage demonstrated a significantly shorter duration to symptom resolution (10.9 days less) and hospital stay (5.2 days shorter).
  • The EUS group experienced fewer repeat sessions (mean 2 vs. 7.7), fewer readmissions (10% vs. 34%), and significantly fewer adverse events (17% vs. 61%).

Conclusions:

  • EUS-guided drainage is an efficacious and safe method for managing hepatic abscesses.
  • It offers advantages over PCD, including faster symptom resolution, shorter hospital stays, reduced adverse events, and fewer procedures.
  • EUS-guided drainage may have limitations for right-sided hepatic abscesses.