Results of EUS Transmural Biliary Drainage

  • Raffaele SalernoEmail author


Endoscopic retrograde cholangiopancreatography (ERCP) for biliary drainage is not always successful due to alterations of the anatomy or because of the inability to access the papilla. Percutaneous transhepatic biliary drainage (PTBD) was traditionally considered the only alternative in these cases. Endoscopic ultrasonography-guided biliary drainage (EUS-BD) represents a valid alternative to PTBD when ERCP fails. According to the site of access to the biliary tree, two kinds of approaches may be recognized: the intrahepatic and the extrahepatic one.

The recent advent of self-expandable metal stents and lumen-apposing metal stents improved this field, but the role of these in EUS-BD is still debated.

Echoendoscopic transmural biliary drainage is challenging with potential severe adverse events. Trained endoscopists in both ERCP and endoscopic ultrasonography are needed with surgical and radiology backup.


Endoscopic ultrasonography-guided biliary drainage (EUS-BD) Percutaneous transhepatic biliary drainage (PTBD) Endoscopic ultrasonography-guided hepatogastric anastomosis (EUS-HPA) Endoscopic ultrasonography-guided antegrade stent placement (EUS-AS) Endoscopic ultrasonography-guided choledochoduodenostomy (EUS-CDS) Endoscopic ultrasonography-guided gallbladder drainage (EUS-GBD) 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Gastroenterology and Endoscopy Unit ASST Fatebenefratelli SaccoMilanItaly

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