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Related Concept Videos

Endoscopic Procedures V: ERCP01:26

Endoscopic Procedures V: ERCP

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Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
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Ultrasound II: Endoscopic Ultrasound and FibroScan01:25

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Endoscopic Ultrasound (EUS) and FibroScan are valuable diagnostic tools in gastroenterology and hepatology, each with specific applications and techniques.
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Endoscopic Procedures I: Esophagogastroduodenoscopy01:29

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An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
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The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
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Related Experiment Video

Updated: Jun 13, 2025

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
07:44

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Endoscopic ultrasound-guided biliary interventions.

Deepak Madhu1, Vinay Dhir2

  • 1Department of Gastroenterology, Caritas Hospital, Kottayam, 686 630, India.

Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology
|September 11, 2024
PubMed
Summary

Endoscopic ultrasound (EUS)-guided biliary drainage (EUS-BD) offers effective alternatives to ERCP for malignant biliary obstruction. Despite challenges like steep learning curves, EUS-BD techniques are evolving into primary interventions.

Keywords:
Endoscopic ultrasound-guided biliary drainageEndoscopic ultrasound-guided choledochoduodenostomyEndoscopic ultrasound-guided gallbladder drainageEndoscopic ultrasound-guided hepaticogastrostomyInterventional endoscopic ultrasoundMalignant biliary obstruction

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Area of Science:

  • Gastroenterology
  • Interventional Endoscopy

Background:

  • Endoscopic retrograde cholangiopancreatography (ERCP) is the standard for biliary drainage, but can fail.
  • Endoscopic ultrasound (EUS)-guided biliary drainage (EUS-BD) procedures emerged as salvage options for failed ERCP.
  • EUS-BD techniques have advanced, becoming first-line options for specific biliary obstructions.

Purpose of the Study:

  • To review various EUS-BD procedures.
  • To detail indications, techniques, outcomes, and follow-up for EUS-BD.

Main Methods:

  • Review of existing literature on EUS-BD procedures.
  • Synthesis of information on EUS-guided hepaticogastrostomy (EUS-HGS), EUS-guided choledochoduodenostomy (EUS-CDS), EUS-guided gallbladder drainage (EUS-GBD), EUS-guided antegrade stenting (EUS-AG), and EUS-guided rendezvous (EUS-RV).

Main Results:

  • EUS-BD, particularly EUS-CDS, shows comparable or superior outcomes to ERCP for malignant biliary obstruction in randomized trials.
  • Transluminal drainage (EUS-HGS, EUS-CDS, EUS-GBD) and transpapillary drainage (EUS-AG) are key EUS-BD methods.
  • EUS-RV facilitates ERCP when cannulation fails.

Conclusions:

  • EUS-BD procedures are effective for biliary drainage, including in malignant obstructions.
  • Widespread adoption is hindered by expertise requirements, learning curves, standardization issues, and cost.
  • Further research and standardization are needed to optimize EUS-BD utilization.