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Updated: Apr 30, 2026

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Update on biliary endoscopy: a comprehensive review.

Yukiko Takayama1, Yousuke Nakai1, Ryunosuke Hakuta1

  • 1Department of Internal Medicine, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan.

Expert Review of Gastroenterology & Hepatology
|April 29, 2026
PubMed
Summary
This summary is machine-generated.

Endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasonography (EUS) are evolving therapeutic tools for biliary tract diseases. Choosing the right endoscopic procedure and devices is crucial for effective patient treatment.

Keywords:
Cholangioscopycholedocholithiasischolestasisendoscopic retrograde cholangiopancreatographyendoscopic ultrasonographystents

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Area of Science:

  • Gastroenterology
  • Endoscopy
  • Biliary Tract Diseases

Background:

  • Endoscopic retrograde cholangiopancreatography (ERCP) has transitioned from diagnostic to therapeutic roles.
  • Endoscopic ultrasonography (EUS) plays a significant role in biliary endoscopy.
  • The expanding indications for endoscopy in biliary diseases necessitate careful selection of procedures and devices.

Purpose of the Study:

  • To review various endoscopic procedures for biliary tract diseases.
  • To discuss treatment selection for bile duct stones and biliary strictures.
  • To highlight advancements in biliary stenting and EUS-guided biliary drainage.

Main Methods:

  • A PubMed search was conducted on biliary endoscopy.
  • Focus on relevant papers without time restrictions.
  • Review of treatment options for bile duct stones and biliary drainage.

Main Results:

  • Treatment for bile duct stones includes ampullary interventions and cholangioscopy-guided lithotripsy.
  • Fully-covered metal stents are common for distal biliary strictures; plastic stents are preferred for unresectable hilar obstructions.
  • EUS-guided biliary drainage (EUS-BD) is an option for difficult ERCP cases and can be a first-line treatment with expertise.

Conclusions:

  • Modified biliary stents with improved features are under development.
  • An individualized approach to stent selection is needed.
  • EUS-BD requires established training for safe performance.