EUS Standard Devices

  • Danilo Castellani
  • Ugo Germani
  • Gabrio Bassotti
  • Raffaele Manta


Endoscopic ultrasonography (EUS) is an established technique for the diagnosis and staging of gastrointestinal (GI) tumors. In the last years, the spread of new devices dedicated to tissue sampling has improved the diagnostic accuracy of EUS fine-needle aspiration (EUS-FNA). The development of EUS-guided drainage of the biliopancreatic region and abdominal fluid collections has allowed EUS to evolve into an interventional tool that can replace more invasive procedures. For instance, techniques using EUS for pancreatic cancer treatment and celiac neurolysis have been described. Moreover, confocal laser endomicroscopy was coupled to EUS for the in vivo histological diagnosis of gastrointestinal, biliopancreatic, and lymph node lesions.

In this chapter, data on EUS devices, with particular emphasis on EUS biopsy, EUS-guided confocal laser endomicroscopy, interventional EUS, and EUS pancreatic cancer treatment, are discussed. All the EUS devices here presented are used with linear array echoendoscopes, image guidance being necessary for device introduction into the target structures. Such a process is not allowed by radial echoendoscopes.


Endoscopic ultrasound Fine-needle aspiration Tissue acquisition Endomicroscopy Stent Fiducial Biliary drainage 


  1. 1.
    Polkowski M, Jenssen C, Kaye P, et al. Technical aspects of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) Technical Guideline—March 2017. Endoscopy. 2017;49:989–1006.PubMedGoogle Scholar
  2. 2.
    Storm AC, Lee LS. Endoscopic ultrasound-guided techniques for diagnosing pancreatic mass lesions: can we do better? World J Gastroenterol. 2016;22:8658–69.PubMedPubMedCentralGoogle Scholar
  3. 3.
    Culp WC, McCowan TC, Goertzen TC, et al. Relative ultrasonographic echogenicity of standard, dimpled, and polymeric-coated needles. J Vasc Interv Radiol. 2000;11:351–8.PubMedGoogle Scholar
  4. 4.
    Adler DG, Conway JD, Coffie JM, et al. EUS accessories. Gastrointest Endosc. 2007;66:1076–81.PubMedGoogle Scholar
  5. 5.
    Tang SJ, Vilmann AS, Saftoiu A, et al. EUS needle identification comparison and evaluation study (with videos). Gastrointest Endosc. 2016;84:424–3300.PubMedPubMedCentralGoogle Scholar
  6. 6.
    ASGE Technology Committee, Hwang JH, et al. Devices for use with EUS. Video GIE. 2017;2(3):35–45.Google Scholar
  7. 7.
    Witt BL, Adler DG, Hilden K, et al. A comparative needle study: EUS-FNA procedures using the HD ProCore™ and EchoTip® 22-gauge needle types. Diagn Cytopathol. 2013;41:1069–74.PubMedGoogle Scholar
  8. 8.
    Bang JY, Hawes R, Varadarajulu S. A meta-analysis comparing ProCore and standard fine-needle aspiration needles for endoscopic ultrasound-guided tissue acquisition. Endoscopy. 2016;48:339–49.PubMedGoogle Scholar
  9. 9.
    Vilmann P, Seicean A, Săftoiu A. Tips to overcome technical challenges in EUS-guided tissue acquisition. Gastrointest Endosc Clin N Am. 2014;24:109–24.PubMedGoogle Scholar
  10. 10.
    Yusuf TE, Ho S, Pavey DA, et al. Retrospective analysis of the utility of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in pancreatic masses, using a 22-gauge or 25-gauge needle system: a multicenter experience. Endoscopy. 2009;41:445–8.PubMedGoogle Scholar
  11. 11.
    Muniraj T, Aslanian HR. New developments in endoscopic ultrasound tissue acquisition. Gastrointest Endosc Clin N Am. 2017;27:585–99.PubMedGoogle Scholar
  12. 12.
    Gimeno-García AZ, Elwassief A, Paquin SC, et al. Endoscopic ultrasound-guided fine needle aspiration cytology and biopsy in the evaluation of lymphoma. Endosc Ultrasound. 2012;1:17–22.PubMedPubMedCentralGoogle Scholar
  13. 13.
    Carrara S, Anderloni A, Jovani M, et al. A prospective randomized study comparing 25-G and 22-G needles of a new platform for endoscopic ultrasound-guided fine needle aspiration of solid masses. Dig Liver Dis. 2016;48:49–54.PubMedGoogle Scholar
  14. 14.
    Vilmann P, Săftoiu A, Hollerbach S, et al. Multicenter randomized controlled trial comparing the performance of 22 gauge versus 25 gauge EUS-FNA needles in solid masses. Scand J Gastroenterol. 2013;48:877–83.PubMedGoogle Scholar
  15. 15.
    Camellini L, Carlinfante G, Azzolini F, et al. A randomized clinical trial comparing 22G and 25G needles in endoscopic ultrasound-guided fine-needle aspiration of solid lesions. Endoscopy. 2011;43:709–15.PubMedGoogle Scholar
  16. 16.
    Lee JK, Lee KT, Choi ER, et al. A prospective, randomized trial comparing 25-gauge and 22-gauge needles for endoscopic ultrasound-guided fine needle aspiration of pancreatic masses. Scand J Gastroenterol. 2013;48:752–7.PubMedGoogle Scholar
  17. 17.
    Fabbri C, Polifemo AM, Luigiano C, et al. Endoscopic ultrasound-guided fine needle aspiration with 22- and 25-gauge needles in solid pancreatic masses: a prospective comparative study with randomisation of needle sequence. Dig Liver Dis. 2011;43:647–52.PubMedGoogle Scholar
  18. 18.
    Siddiqui UD, Rossi F, Rosenthal LS, et al. EUS-guided FNA of solid pancreatic masses: a prospective, randomized trial comparing 22-gauge and 25-gauge needles. Gastrointest Endosc. 2009;70:1093–7.PubMedGoogle Scholar
  19. 19.
    Lee JH, Stewart J, Ross WA, et al. Blinded prospective comparison of the performance of 22-gauge and 25-gauge needles in endoscopic ultrasound-guided fine needle aspiration of the pancreas and peri-pancreatic lesions. Dig Dis Sci. 2009;54:2274–81.PubMedGoogle Scholar
  20. 20.
    Facciorusso A, Stasi E, Di Maso M, et al. Endoscopic ultrasound-guided fine needle aspiration of pancreatic lesions with 22 versus 25 gauge needles: a meta-analysis. United European Gastroenterol J. 2017;5:846–53.PubMedGoogle Scholar
  21. 21.
    Xu MM, Jia HY, Yan LL, et al. Comparison of two different size needles in endoscopic ultrasound-guided fine-needle aspiration for diagnosing solid pancreatic lesions: a meta-analysis of prospective controlled trials. Medicine (Baltimore). 2017;96:e5802.Google Scholar
  22. 22.
    Madhoun MF, Wani SB, Rastogi A, et al. The diagnostic accuracy of 22-gauge and 25-gauge needles in endoscopic ultrasound-guided fine needle aspiration of solid pancreatic lesions: a meta-analysis. Endoscopy. 2013;45:86–92.PubMedGoogle Scholar
  23. 23.
    Affolter KE, Schmidt RL, Matynia AP, et al. Needle size has only a limited effect on outcomes in EUS-guided fine needle aspiration: a systematic review and meta-analysis. Dig Dis Sci. 2013;58:1026–34.PubMedGoogle Scholar
  24. 24.
    Song TJ, Kim JH, Lee SS, et al. The prospective randomized, controlled trial of endoscopic ultrasound-guided fine-needle aspiration using 22G and 19G aspiration needles for solid pancreatic or peripancreatic masses. Am J Gastroenterol. 2010;105:1739–45.PubMedGoogle Scholar
  25. 25.
    Sakamoto H, Kitano M, Komaki T, et al. Prospective comparative study of the EUS guided 25-gauge FNA needle with the 19-gauge trucut needle and 22-gauge FNA needle in patients with solid pancreatic masses. J Gastroenterol Hepatol. 2009;24:384–90.PubMedGoogle Scholar
  26. 26.
    Varadarajulu S, Bang JY, Hebert-Magee S. Assessment of the technical performance of the flexible 19-gauge EUS-FNA needle. Gastrointest Endosc. 2012;76:336–43.PubMedGoogle Scholar
  27. 27.
    DeWitt J, Cho CM, Lin J, et al. Comparison of EUS-guided tissue acquisition using two different 19-gauge core biopsy needles: a multicenter, prospective, randomized, and blinded study. Endosc Int Open. 2015;3:E471–8.PubMedPubMedCentralGoogle Scholar
  28. 28.
    Stavropoulos SN, Im GY, Jlayer Z, et al. High yield of same-session EUS-guided liver biopsy by 19-gauge FNA needle in patients undergoing EUS to exclude biliary obstruction. Gastrointest Endosc. 2012;75:310–8.PubMedGoogle Scholar
  29. 29.
    Diehl DL, Johal AS, Khara HS, et al. Endoscopic ultrasound-guided liver biopsy: a multicenter experience. Endosc Int Open. 2015;3:E210–5.PubMedPubMedCentralGoogle Scholar
  30. 30.
    Pineda JJ, Diehl DL, Miao CL, et al. EUS-guided liver biopsy provides diagnostic samples comparable with those via the percutaneous or transjugular route. Gastrointest Endosc. 2016;83:360–5.PubMedGoogle Scholar
  31. 31.
    Kim GH, Cho YK, Kim EY, et al. Comparison of 22-gauge aspiration needle with 22-gauge biopsy needle in endoscopic ultrasonography-guided subepithelial tumor sampling. Scand J Gastroenterol. 2014;49:347–54.PubMedGoogle Scholar
  32. 32.
    Muniraj T, Sah RP, Chari ST. Autoimmune pancreatitis: an update. In: Pancreatitis: medical and surgical management. Chichester: Wiley; 2017. p. 152–60.Google Scholar
  33. 33.
    Karadsheh Z, Al-Haddad M. Endoscopic ultrasound guided fine needle tissue acquisition: where we stand in 2013? World J Gastroenterol. 2014;20:2176–85.PubMedPubMedCentralGoogle Scholar
  34. 34.
    Adler DG, Witt B, Chadwick B, et al. Pathologic evaluation of a new endoscopic ultrasound needle designed to obtain core tissue samples: a pilot study. Endosc Ultrasound. 2016;5:178–83.PubMedPubMedCentralGoogle Scholar
  35. 35.
    Bang JY, Hebert-Magee S, Hasan MK, et al. Endoscopic ultrasonography-guided biopsy using a Franseen needle design: initial assessment. Dig Endosc. 2017;29:338–46.PubMedGoogle Scholar
  36. 36.
    Kandel P, Tranesh G, Nassar A, et al. EUS-guided fine needle biopsy sampling using a novel fork-tip needle: a case-control study. Gastrointest Endosc. 2016;84:1034–9.PubMedGoogle Scholar
  37. 37.
    DiMaio CJ, Kolb JM, Benias PC, et al. Initial experience with a novel EUS-guided core biopsy needle (SharkCore): results of a large North American Multicenter Study. Endosc Int Open. 2016;4:E974–9.PubMedPubMedCentralGoogle Scholar
  38. 38.
    Attam R, Arain M, Trikudanathan G, et al. EUS-guided pancreatic duct access and wire placement to facilitate dorsal duct cannulation after failed ERCP. Gastrointest Endosc. 2015;81:1260.PubMedGoogle Scholar
  39. 39.
    Khashab MA, Van der Merwe S, Kunda R, et al. Prospective international multicenter study on endoscopic ultrasound-guided biliary drainage for patients with malignant distal biliary obstruction after failed endoscopic retrograde cholangiopancreatography. Endosc Int Open. 2016;4:E487–96.PubMedPubMedCentralGoogle Scholar
  40. 40.
    LeBlanc JK, Al-Haddad M, McHenry L, et al. A prospective, randomized study of EUS-guided celiac plexus neurolysis for pancreatic cancer: one injection or two? Gastrointest Endosc. 2011;74:1300–7.PubMedGoogle Scholar
  41. 41.
    Gress F, Schmitt C, Sherman S, et al. A prospective randomized comparison of endoscopic ultrasound- and computed tomography-guided celiac plexus block for managing chronic pancreatitis pain. Am J Gastroenterol. 1999;94:900–5.PubMedGoogle Scholar
  42. 42.
    Wiersema MJ, Wiersema LM. Endosonography-guided celiac plexus neurolysis. Gastrointest Endosc. 1996;44:656–62.PubMedGoogle Scholar
  43. 43.
    Kaufman M, Singh G, Das S, et al. Efficacy of endoscopic ultrasound-guided celiac plexus block and celiac plexus neurolysis for managing abdominal pain associated with chronic pancreatitis and pancreatic cancer. J Clin Gastroenterol. 2010;44:127–34.PubMedGoogle Scholar
  44. 44.
    Lee JK, Choi JH, Lee KH, et al. A prospective, comparative trial to optimize sampling techniques in EUS-guided FNA of solid pancreatic masses. Gastrointest Endosc. 2013;77:745–51.PubMedGoogle Scholar
  45. 45.
    Puri R, Vilmann P, Saftoiu A, et al. Randomized controlled trial of endoscopic ultrasound-guided fine-needle sampling with or without suction for better cytological diagnosis. Scand J Gastroenterol. 2009;44:499–504.PubMedGoogle Scholar
  46. 46.
    Nakai Y, Isayama H, Chang KJ, et al. Slow pull versus suction in endoscopic ultrasound-guided fine-needle aspiration of pancreatic solid masses. Dig Dis Sci. 2014;59:1578–85.PubMedGoogle Scholar
  47. 47.
    Wallace MB, Kennedy T, Durkalski V, et al. Randomized controlled trial of EUS-guided fine needle aspiration techniques for the detection of malignant lymphadenopathy. Gastrointest Endosc. 2001;54:441–7.PubMedGoogle Scholar
  48. 48.
    Wani S, Muthusamy VR, Komanduri S. EUS-guided tissue acquisition: an evidence-based approach (with videos). Gastrointest Endosc. 2014;80:939–59.e7.PubMedGoogle Scholar
  49. 49.
    Rastogi A, Wani S, Gupta N, et al. A prospective, single-blind, randomized, controlled trial of EUS-guided FNA with and without a stylet. Gastrointest Endosc. 2011;74:58–64.PubMedGoogle Scholar
  50. 50.
    Wani S, Gupta N, Gaddam S, et al. A comparative study of endoscopic ultrasound guided fine needle aspiration with and without a stylet. Dig Dis Sci. 2011;56:2409–14.PubMedGoogle Scholar
  51. 51.
    ASGE Standards of Practice Committee, Early DS, Acosta RD, Chandrasekhara V, et al. Adverse events associated with EUS and EUS with FNA. Gastrointest Endosc. 2013;77:839–43.Google Scholar
  52. 52.
    Wang KX, Ben QW, Jin ZD, et al. Assessment of morbidity and mortality associated with EUS-guided FNA: a systematic review. Gastrointest Endosc. 2011;73:283–90.PubMedGoogle Scholar
  53. 53.
    Lee YN, Moon JH, Kim HK, et al. Core biopsy needle versus standard aspiration needle for endoscopic ultrasound-guided sampling of solid pancreatic masses: a randomized parallel-group study. Endoscopy. 2014;46:1056–62.PubMedGoogle Scholar
  54. 54.
    Nakai Y, Iwashita T, Park DH, et al. Diagnosis of pancreatic cysts: EUS-guided, through-the-needle confocal laser-induced endomicroscopy and cystoscopy trial: DETECT study. Gastrointest Endosc. 2015;81:1204–14.PubMedGoogle Scholar
  55. 55.
    Stavropoulos SN, Abraham B, Friedel D, et al. Direct visualization of the wall of pancreatic cysts using the SPYGLASS optical probe: feasibility and preliminary results. Gastrointest Endosc. 2009;69:AB377.Google Scholar
  56. 56.
    Al-Haddad M, Raimondo M, Woodward T, et al. Safety and efficacy of cytology brushings versus standard FNA in evaluating cystic lesions of the pancreas: a pilot study. Gastrointest Endosc. 2007;65:894–8.PubMedGoogle Scholar
  57. 57.
    Lozano MD, Subtil JC, Miravalles TL, et al. EchoBrush may be superior to standard EUS-guided FNA in the evaluation of cystic lesions of the pancreas: preliminary experience. Cancer Cytopathol. 2011;119:209–14.PubMedGoogle Scholar
  58. 58.
    Al-Haddad M, Gill KR, Raimondo M, et al. Safety and efficacy of cytology brushings versus standard fine-needle aspiration in evaluating cystic pancreatic lesions: a controlled study. Endoscopy. 2010;42:127–32.PubMedGoogle Scholar
  59. 59.
    Bruno M, Bosco M, Carucci P, et al. Preliminary experience with a new cytology brush in EUS-guided FNA. Gastrointest Endosc. 2009;70:1220–4.PubMedGoogle Scholar
  60. 60.
    Thomas T, Bebb J, Mannath J, et al. EUS-guided pancreatic cyst brushing: a comparative study in a tertiary referral centre. JOP. 2010;11:163–9.PubMedGoogle Scholar
  61. 61.
    Samarasena JB, Nakai Y, Shinoura S, et al. EUS-guided, through-the-needle forceps biopsy: a novel tissue acquisition technique. Gastrointest Endosc. 2015;81:225–6.PubMedGoogle Scholar
  62. 62.
    Coman RM, Schlachterman A, Esnakula AK, et al. EUS-guided, through-the-needle forceps: clenching down the diagnosis. Gastrointest Endosc. 2016;84:372–3.PubMedGoogle Scholar
  63. 63.
    Shakhatreh MH, Naini SR, Brijbassie AA, et al. Use of a novel through-the-needle biopsy forceps in endoscopic ultrasound. Endosc Int Open. 2016;4:E439–42.PubMedPubMedCentralGoogle Scholar
  64. 64.
    Nakai Y, Isayama H, Chang KJ, et al. A pilot study of EUS-guided through-the-needle forceps biopsy (with video). Gastrointest Endosc. 2016;84:158–62.PubMedGoogle Scholar
  65. 65.
    Kiesslich R, Burg J, Vieth M, et al. Confocal laser endoscopy for diagnosing intraepithelial neoplasias and colorectal cancer in vivo. Gastroenterology. 2004;127:706–13.PubMedGoogle Scholar
  66. 66.
    Kiesslich R, Neurath MF. Endomicroscopy is born—do we still need the pathologist? Gastrointest Endosc. 2007;66:150–3.PubMedGoogle Scholar
  67. 67.
    Bhutani MS, Koduru P, Joshi V, et al. EUS-guided needle-based confocal laser endomicroscopy: a novel technique with emerging applications. Gastroenterol Hepatol (N Y). 2015;11:235–40.Google Scholar
  68. 68.
    Deprez PH. Future directions in EUS-guided tissue acquisition. Gastrointest Endosc Clin N Am. 2014;24:143–9.PubMedGoogle Scholar
  69. 69.
    Napoléon B, Lemaistre AI, Pujol B, et al. A novel approach to the diagnosis of pancreatic serous cystadenoma: needle-based confocal laser endomicroscopy. Endoscopy. 2015;47:26–32.PubMedGoogle Scholar
  70. 70.
    Joshi V. NCLE (needle-based confocal laser endomicroscopy) in evaluation of indeterminate pancreatic cystic lesions: a single-center experience. Am J Gastroenterol. 2014;109(Suppl 2):S101–23.Google Scholar
  71. 71.
    Krishna SG, Brugge WR, Dewitt JM, et al. Needle-based confocal laser endomicroscopy for the diagnosis of pancreatic cystic lesions: an international external interobserver and intraobserver study (with videos). Gastrointest Endosc. 2017;86:644–5400.PubMedGoogle Scholar
  72. 72.
    Kadayifci A, Atar M, Basar O, et al. Needle-based confocal laser endomicroscopy for evaluation of cystic neoplasms of the pancreas. Dig Dis Sci. 2017;62:1346–53.PubMedGoogle Scholar
  73. 73.
    Karstensen JG, Cartana T, Klausen P, et al. Mo1430 pitfalls in the interpretation of pancreatic endoscopic ultrasound guided needle confocal LASER endomicroscopy. Gastrointest Endosc. 2014;79:AB433–4.Google Scholar
  74. 74.
    Giovannini M, Caillol F, Monges G, et al. Endoscopic ultrasound-guided needle-based confocal laser endomicroscopy in solid pancreatic masses. Endoscopy. 2016;48:892–8.PubMedGoogle Scholar
  75. 75.
    Nakai Y, Shinoura S, Ahluwalia A, et al. In vivo visualization of epidermal growth factor receptor and survivin expression in porcine pancreas using endoscopic ultrasound guided fine needle imaging with confocal laser-induced endomicroscopy. J Physiol Pharmacol. 2012;63:577–80.PubMedGoogle Scholar
  76. 76.
    Samarasena JB, Tarnawski AS, Shinoura S, et al. Mo1429 visualization of the gastric submucosal and myenteric neuronal network using endoscopic ultrasound (EUS) guided needle-based confocal LASER induced endomicroscopy and a novel EUS guided through-the-needle biopsy technique. Gastrointest Endosc. 2014;79:AB433.Google Scholar
  77. 77.
    Li H, Li Y, Cui L, et al. Monitoring pancreatic carcinogenesis by the molecular imaging of cathepsin E in vivo using confocal laser endomicroscopy. PLoS One. 2014;9:e106566.PubMedPubMedCentralGoogle Scholar
  78. 78.
    Guo J, Bhutani MS, Giovannini M, et al. Can endoscopic ultrasound-guided needle-based confocal laser endomicroscopy replace fine-needle aspiration for pancreatic and mediastinal diseases? Endosc Ultrasound. 2017;6:376–81.PubMedPubMedCentralGoogle Scholar
  79. 79.
    DiMaio CJ, Nagula S, Goodman KA, et al. EUS-guided fiducial placement for image-guided radiation therapy in GI malignancies by using a 22-gauge needle (with videos). Gastrointest Endosc. 2010;71:1204–10.PubMedGoogle Scholar
  80. 80.
    van der Horst A, Wognum S, Davila Fajardo R, et al. Interfractional position variation of pancreatic tumors quantified using intratumoral fiducial markers and daily cone beam computed tomography. Int J Radiat Oncol Biol Phys. 2013;87:202–8.PubMedGoogle Scholar
  81. 81.
    Binmoeller KF, Shah J. A novel lumen-apposing stent for transluminal drainage of nonadherent extraintestinal fluid collections. Endoscopy. 2011;43:337–42.PubMedGoogle Scholar
  82. 82.
    Shah RJ, Shah JN, Waxman I, et al. Safety and efficacy of endoscopic ultrasound-guided drainage of pancreatic fluid collections with lumen-apposing covered self-expanding metal stents. Clin Gastroenterol Hepatol. 2015;13:747–52.PubMedGoogle Scholar
  83. 83.
    Irani S, Baron TH, Grimm IS, et al. EUS-guided gallbladder drainage with a lumen-apposing metal stent (with video). Gastrointest Endosc. 2015;82:1110–5.PubMedGoogle Scholar
  84. 84.
    Teoh AY, Binmoeller KF, Lau JY. Single-step EUS-guided puncture and delivery of a lumen-apposing stent for gallbladder drainage using a novel cautery-tipped stent delivery system. Gastrointest Endosc. 2014;80:1171.PubMedGoogle Scholar
  85. 85.
    Walter D, Teoh AY, Itoi T, et al. EUS-guided gall bladder drainage with a lumen-apposing metal stent: a prospective long-term evaluation. Gut. 2016;65:6–8.PubMedGoogle Scholar
  86. 86.
    Minaga K, Kitano M. Recent advances in endoscopic ultrasound-guided biliary drainage. Dig Endosc. 2018;30(1):38–47.PubMedGoogle Scholar
  87. 87.
    Giovannini M, Moutardier V, Pesenti C, Bories E, Lelong B, Delpero JR. Endoscopic ultrasound-guided bilioduodenal anastomosis: a new technique for biliary drainage. Endoscopy. 2001;33:898–900.PubMedGoogle Scholar
  88. 88.
    Khan MA, Akbar A, Baron TH, et al. Endoscopic ultrasound-guided biliary drainage: a systematic review and meta-analysis. Dig Dis Sci. 2016;61:684–703.PubMedGoogle Scholar
  89. 89.
    Wang K, Zhu J, Xing L, Wang Y, Jin Z, Li Z. Assessment of efficacy and safety of EUS-guided biliary drainage: a systematic review. Gastrointest Endosc. 2016;83:1218–27.PubMedGoogle Scholar
  90. 90.
    Itoi T, Sofuni A, Itokawa F, et al. Endoscopic ultrasonography-guided biliary drainage. J Hepatobiliary Pancreat Sci. 2010;17:611–6.PubMedGoogle Scholar
  91. 91.
    Moole H, Bechtold ML, Forcione D, Puli SR. A meta-analysis and systematic review: success of endoscopic ultrasound guided biliary stenting in patients with inoperable malignant biliary strictures and a failed ERCP. Medicine. 2017;96:e5154.PubMedPubMedCentralGoogle Scholar
  92. 92.
    Hara K, Yamao K, Mizuno N, et al. Endoscopic ultrasonography-guided biliary drainage: who, when, which, and how? World J Gastroenterol. 2016;22:1297–303.PubMedPubMedCentralGoogle Scholar
  93. 93.
    Bruno MJ. Interventional endoscopic ultrasonography: where are we headed? Dig Endosc. 2017;29:503–11.PubMedGoogle Scholar
  94. 94.
    Iwashita T, Doi S, Yasuda I. Endoscopic ultrasound-guided biliary drainage: a review. Clin J Gastroenterol. 2014;7:94–102.PubMedPubMedCentralGoogle Scholar
  95. 95.
    Chan SM, Teoh AY. Endoscopic ultrasound-guided biliary drainage: a review. Curr Treat Options Gastroenterol. 2015;13:171–84.PubMedGoogle Scholar
  96. 96.
    Ryozawa S, Fujita N, Irisawa A, Hirooka Y, Mine T. Current status of interventional endoscopic ultrasound. Dig Endosc. 2017;29:559–66.PubMedGoogle Scholar
  97. 97.
    Ogura T, Higuchi K. Technical tips of endoscopic ultrasound-guided choledochoduodenostomy. World J Gastroenterol. 2015;21:820–8.PubMedPubMedCentralGoogle Scholar
  98. 98.
    Cho DH, Lee SS, Oh D, et al. Long-term outcomes of a newly developed hybrid metal stent for EUS-guided biliary drainage (with videos). Gastrointest Endosc. 2017;85:1067–75.PubMedGoogle Scholar
  99. 99.
    Kunda R, Pérez-Miranda M, Will U, et al. EUS-guided choledochoduodenostomy for malignant distal biliary obstruction using a lumen-apposing fully covered metal stent after failed ERCP. Surg Endosc. 2016;30:5002–8.PubMedGoogle Scholar
  100. 100.
    Burmester E, Niehaus J, Leineweber T, Huetteroth T. EUS-cholangio-drainage of the bile duct: report of 4 cases. Gastrointest Endosc. 2003;57:246–51.PubMedGoogle Scholar
  101. 101.
    Ogura T, Onda S, Takagi W, et al. Clinical utility of endoscopic ultrasound-guided biliary drainage as a rescue of re-intervention procedure for high-grade hilar stricture. J Gastroenterol Hepatol. 2017;32:163–8.PubMedGoogle Scholar
  102. 102.
    Ogura T, Higuchi K. Technical tips for endoscopic ultrasound-guided hepaticogastrostomy. World J Gastroenterol. 2016;22:3945–51.PubMedPubMedCentralGoogle Scholar
  103. 103.
    Oh D, Park DH, Song TJ, et al. Optimal biliary access point and learning curve for endoscopic ultrasound-guided hepaticogastrostomy with transmural stenting. Ther Adv Gastroenterol. 2017;10:42–53.Google Scholar
  104. 104.
    Minaga K, Kitano M, Yoshikawa T, et al. Hepaticogastrostomy guided by real-time contrast-enhanced harmonic endoscopic ultrasonography: a novel technique. Endoscopy. 2016;48(Suppl 1):E228–9.PubMedGoogle Scholar
  105. 105.
    Nakai Y, Isayama H, Yamamoto N, et al. Safety and effectiveness of a long, partially covered metal stent for endoscopic ultrasound-guided hepaticogastrostomy in patients with malignant biliary obstruction. Endoscopy. 2016;48:1125–8.PubMedGoogle Scholar
  106. 106.
    Martins FP, Rossini LGB, Ferrari AP. Migration of a covered metallic stent following endoscopic ultrasound-guided hepaticogastrostomy. Endoscopy. 2010;42:E126–7.PubMedGoogle Scholar
  107. 107.
    Minaga K, Kitano M, Yamashita Y, Nakatani Y, Kudo M. Stent migration into the abdominal cavity after EUS-guided hepaticogastrostomy. Gastrointest Endosc. 2017;85:263–4.PubMedGoogle Scholar
  108. 108.
    Ogura T, Yamamoto K, Sano T, et al. Stent length is impact factor associated with stent patency in endoscopic ultrasound-guided hepaticogastrostomy. J Gastroenterol Hepatol. 2015;30:1748–52.PubMedGoogle Scholar
  109. 109.
    Paik WH, Park DH, Choi JH, et al. Simplified fistula dilation technique and modified stent deployment maneuver for EUS-guided hepaticogastrostomy. World J Gastroenterol. 2014;20:5051–9.PubMedPubMedCentralGoogle Scholar
  110. 110.
    Mallery S, Matlock J, Freeman ML. EUS-guided rendezvous drainage of obstructed biliary and pancreatic ducts: report of 6 cases. Gastrointest Endosc. 2004;59:100–7.PubMedGoogle Scholar
  111. 111.
    Isayama H, Nakai Y, Kawakubo K, et al. The endoscopic ultrasonography-guided rendezvous technique for biliary cannulation: a technical review. J Hepatobiliary Pancreat Sci. 2013;20:413–20.PubMedGoogle Scholar
  112. 112.
    Kahaleh M, Hernandez AJ, Tokar J, Adams RB, Shami VM, Yeaton P. Interventional EUS-guided cholangiography: evaluation of a technique in evolution. Gastrointest Endosc. 2006;64:52–9.PubMedGoogle Scholar
  113. 113.
    Dhir V, Bhandari S, Bapat M, Maydeo A. Comparison of EUS-guided rendezvous and precut papillotomy techniques for biliary access (with videos). Gastrointest Endosc. 2012;75:354–9.PubMedGoogle Scholar
  114. 114.
    Iwashita T, Lee JG, Shinoura S, et al. Endoscopic ultrasound-guided rendezvous for biliary access after failed cannulation. Endoscopy. 2012;44:60–5.PubMedGoogle Scholar
  115. 115.
    Iwashita T, Yasuda I, Mukai T, et al. EUS-guided rendezvous for difficult biliary cannulation using a standardized algorithm: a multicenter prospective pilot study (with videos). Gastrointest Endosc. 2016;83:394–400.PubMedGoogle Scholar
  116. 116.
    Fujita N, Noda Y, Kobayashi G, et al. Temporary endosonography-guided biliary drainage for transgastrointestinal deployment of a self-expandable metallic stent. J Gastroenterol. 2008;43:637–40.PubMedGoogle Scholar
  117. 117.
    Iwashita T, Yasuda I, Mukai T, et al. Endoscopic ultrasound-guided antegrade biliary stenting for unresectable malignant biliary obstruction in patients with surgically altered anatomy: a single-center prospective pilot study. Dig Endosc. 2017;29:362–8.PubMedGoogle Scholar
  118. 118.
    Ogura T, Masuda D, Imoto A, et al. EUS-guided hepaticogastrostomy combined with fine-gauge antegrade stenting: a pilot study. Endoscopy. 2014;46:416–21.PubMedGoogle Scholar
  119. 119.
    Minaga K, Takenaka M, Miyata T, Ueda Y, Kitano M, Kudo M. Through-the-mesh technique after endoscopic ultrasonography-guided hepaticogastrostomy: a novel re-intervention method. Endoscopy. 2016;48:E369–70.PubMedGoogle Scholar
  120. 120.
    Holt BA, Hawes R, Hasan M, et al. Biliary drainage: role of EUS guidance. Gastrointest Endosc. 2016;83:160–5.PubMedGoogle Scholar
  121. 121.
    Hara K, Yamao K, Niwa Y, et al. Prospective clinical study of EUS-guided choledochoduodenostomy for malignant lower biliary tract obstruction. Am J Gastroenterol. 2011;106:1239–45.PubMedGoogle Scholar
  122. 122.
    Kawakubo K, Kawakami H, Kuwatani M, et al. Endoscopic ultrasound-guided choledochoduodenostomy vs. transpapillary stenting for distal biliary obstruction. Endoscopy. 2016;48:164–9.PubMedGoogle Scholar
  123. 123.
    Dhir V, Itoi T, Khashab MA, et al. Multicenter comparative evaluation of endoscopic placement of expandable metal stents for malignant distal common bile duct obstruction by ERCP or EUS-guided approach. Gastrointest Endosc. 2015;81:913–23.PubMedGoogle Scholar
  124. 124.
    Nakai Y, Isayama H, Yamamoto N, et al. Indications for endoscopic ultrasonography (EUS)-guided biliary intervention: does EUS always come after failed endoscopic retrograde cholangiopancreatography? Dig Endosc. 2017;29:218–25.PubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Danilo Castellani
    • 1
  • Ugo Germani
    • 1
  • Gabrio Bassotti
    • 2
  • Raffaele Manta
    • 1
  1. 1.Gastroenterology UnitPerugia General HospitalPerugiaItaly
  2. 2.Gastroenterology and Hepatology Section, Department of MedicineUniversity of Perugia Medical SchoolPerugiaItaly

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