Open AccessEUS-guided biliary drainage for malignant hilar biliary obstruction: A concise review
Author(s) -
Sridhar Sundaram,
Vinay Dhir
Publication year - 2021
Publication title -
endoscopic ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.883
H-Index - 24
eISSN - 2303-9027
pISSN - 2226-7190
DOI - 10.4103/eus-d-21-00004
Subject(s) - medicine , biliary drainage , radiology , biliary stent , stent , percutaneous , drainage , ecology , biology
EUS-guided biliary drainage (EUS-BD) has emerged as an alternative to ERCP for distal biliary obstruction in expert hands. Various routes for EUS-guided access in distal biliary obstruction include EUS choledochoduodenostomy, EUS-guided rendezvous, and EUS-antegrade (EUS-AG) stent placement. While percutaneous transhepatic biliary drainage and ERCP are established modalities in management of malignant hilar biliary obstruction, the role of EUS-BD is emerging. Various methods of drainage in hilar obstruction include EUS hepaticogastrostomy, EUS hepaticoduodenostomy, EUS-guided bridging stent placement, and combined ERCP and EUS-guided biliary drainage. In this review, we discuss the role of EUS-BD in malignant hilar biliary obstruction with the currently available evidence, along with the limitations and challenges to the use of this modality in management of these patients.