Drainage of the right liver under EUS guidance: A bridge technique allowing drainage of the right liver through the left liver into the stomach or jejunum.

Background And Objective: EUS-guided biliary drainage is now comparable to percutaneous drainage. This technique can be used in cases of complex drainage of the hilum, mainly for salvage therapy to drain the left liver. In cases of inaccessible papilla or altered anatomy, EUS-guided biliary drainage for hilar stenosis of the liver could be used as the first approach.

Precut papillotomy: a risky technique not only for experts but also for average endoscopists skilled in ERCP.

Purpose: To evaluate the success and complication rates of early precut papillotomy in difficult biliary cannulations performed by an average endoscopist skilled in ERCP.

Methods: We studied 146 consecutive ERCPs during a 27-month period. Precutting was instituted if cannulation failed after 10-15 min.