Chapter5 1 5. EUS-Guided Biliary Drainage

Abstract Endoscopic ultrasound-guided biliary drainage (EUS-BD) has been developed as an alternative method for failed endoscopic retrograde cholangiopancreatography (ERCP). EUS-BD can be divided into two main approach routes, such as transgastric or transduodenal approach. Also, EUS-guided hepaticogastrostomy, choledochoduodenostomy (CDS), and gallbladder drainage (GBD) have been reported. In this chapter, we described technical tips for each basic technique, including literature review. As advanced technique of EUS-BD, antegrade stone removal has been reported. More recently, electrohydraulic lithotripsy for bile duct stones under transluminal cholangioscopy guidance, hepaticojejunostomy stricture dilation through EUS-hepaticogastrostomy (HGS) route, or EUS-guided gastrojejunostomy has been reported. Although EUS-BD has various potential as treatment technique, treatment method should be selected for each patient’s conditions.