| Theme |
Malignant Biliary Stricture -- Recent Advancements on Diagnosis & Treatment |
| Title |
EUS-guided Biliary Drainage |
| Author |
Takuji Iwashita |
First Department of Internal Medicine, Gifu University Hospital |
| Author |
Ichiro Yasuda |
First Department of Internal Medicine, Gifu University Hospital |
| Author |
Shinpei Doi |
First Department of Internal Medicine, Gifu University Hospital |
| Author |
Shinya Uemura |
First Department of Internal Medicine, Gifu University Hospital |
| Author |
Masatoshi Mabuchi |
First Department of Internal Medicine, Gifu University Hospital |
| Author |
Hisataka Moriwaki |
First Department of Internal Medicine, Gifu University Hospital |
| [ Summary ] |
Endoscopic ultrasound-guided biliary drainage (EUS-BD) has recently emerged as alternative drainage technique after failed ERCP. EUS-BD is divided into 3 different techniques. 1) EUS-guided transluminal biliary drainage : a fistula is created for biliary drainage between the intestine and the biliary duct under EUS guidance. 2) EUS-rendezvous : a guidewire is placed through a FNA needle, the biliary duct and ampulla and into the intestine under EUS-guidance, followed by biliary cannulation. 3) EUS-guided antegrade treatment：stent placement is performed through a temporal fistula which is created between the intestine and the biliary duct under EUS-guidance. All 3 EUS-BD techniques require endoscopistʼs expertise in both EUS and ERCP procedures, since these procedures contain technical factors used in EUS and ERCP. The availability of alternative biliary decompression, such as PTBD or surgery, is also crucial to minimize the risk of complications in preparation for unsuccessful EUS-BD. |