AI Article Synopsis
- ERCP remains the standard treatment for unresectable malignant biliary obstruction, but EUS-guided biliary drainage is increasingly recognized for complicated cases where ERCP fails or isn't possible.
- Recent studies indicate that EUS-guided methods, like hepaticogastrostomy and choledochoduodenostomy, may be just as effective, if not better, than ERCP for the initial treatment of these obstructions.
- The article discusses the different procedural techniques and evaluates the safety and efficacy of the various methods based on recent comparative literature.
Article Abstract
Endoscopic retrograde cholangiopancreatography (ERCP) is the standard of care in the management of unresectable malignant biliary obstruction. However, endoscopic ultrasound (EUS)-guided biliary drainage has become widely accepted over the past several years for complicated biliary drainage in cases when ERCP is unsuccessful or not feasible. Recent emerging evidence suggests EUS-guided hepaticogastrostomy and EUS-guided choledochoduodenostomy are noninferior, and possibly even superior to conventional ERCP for primary palliation of malignant biliary obstruction. This article reviews the procedural techniques and considerations of the different techniques as well as comparative literature on safety and efficacy between techniques.
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| http://dx.doi.org/10.1097/MCG.0000000000001854 | DOI Listing |
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