Published online May 16, 2019. doi: 10.4253/wjge.v11.i5.345
Peer-review started: March 20, 2019
First decision: May 8, 2019
Revised: May 11, 2019
Accepted: May 13, 2019
Article in press: May 14, 2019
Published online: May 16, 2019
Processing time: 60 Days and 2.7 Hours
Endoscopic ultrasound-guided biliary drainage (EUS-BD) has been developed as an alternative means of biliary drainage for malignant biliary obstruction (MBO). Compared to percutaneous transhepatic biliary drainage, EUS-BD offers effective internal drainage in a single session in the event of failed endoscopic retrograde cholangiopancreatography and has fewer adverse events (AE). In choosing which technique to use for EUS-BD, a combination of factors appears to be important in decision-making; technical expertise, the risk of AE, and anatomy. With the advent of novel all-in-one EUS-BD specific devices enabling simpler and safer techniques, as well as the growing experience and training of endosonographers, EUS-BD may potentially become a first-line technique in biliary drainage for MBO.
Core tip: Endoscopic ultrasound-guided biliary drainage (EUS-BD) has been developed as an alternative means of biliary drainage for malignant biliary obstruction. EUS-BD must replace percutaneous transhepatic biliary drainage as the salvage procedure of choice in failed endoscopic retrograde cholangiopancreatography when endoscopic expertise is available. The advent of novel all-in-one EUS-BD specific devices, as well as the growing experience and training of endosonographers are promising for the development of EUS-BD as a first-line technique.