title: Endoscopic ultrasonography-guided biliary drainage.
abstract: OBJECTIVE
  Endoscopic ultrasonography-guided biliary drainage (EUS-BD) has been developed as an alternative drainage method in patients with obstructive jaundice. EUS-BD is divided into EUS-guided choledochoduodenostomy (EUS-CDS), EUS-guided hepaticogastrostomy (EUS-HGS) and EUS-guided gallbladder drainage (EUS-GBD). The aim of this review is to focus on the current status and limitations of EUS-BD.
  
  
  METHODS
  A systematic review was performed to evaluate EUS-BD. MEDLINE, EMBASE and manual searches were performed to identify the pertinent English language full articles.
  
  
  RESULTS
  The high success rate without fatal adverse events for EUS-CDS (93%; 28/30) and EUS-HGS (97%; 28/29) suggest the feasibility and safety of the procedures in high-volume endoscopic centers adopting various procedural techniques. Although the number of reported cases was very small, the success rate of EUS-GBD was high (100%; 14/14), without serious adverse events.
  
  
  CONCLUSIONS
  Although all procedures require further assessment in a larger cohort of patients, including comparative studies between EUS-CDS or EUS-HGS versus PTBD, and EUS-GBD versus PTGBD, EUS-BD may be a promising procedure for the treatment of obstructive jaundice. However, dedicated devices for EUS-guided drainage are needed for reliable procedures.
authors.affiliation: Department of Gastroenterology and Hepatology, Tokyo Medical University, Shinjuku-ku, Nishishinjuku 6-7-1, Tokyo, Japan. itoi@tokyo-med.ac.jp
authors.forename: Takao
authors.initials: T
authors.lastname: Itoi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sofuni
authors.forename: Fumihide
authors.initials: F
authors.lastname: Itokawa
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Tsuchiya
authors.forename: Toshio
authors.initials: T
authors.lastname: Kurihara
authors.forename: Kentaro
authors.initials: K
authors.lastname: Ishii
authors.forename: Shujiro
authors.initials: S
authors.lastname: Tsuji
authors.forename: Nobuhito
authors.initials: N
authors.lastname: Ikeuchi
authors.forename: Junko
authors.initials: J
authors.lastname: Umeda
authors.forename: Fuminori
authors.initials: F
authors.lastname: Moriyasu
authors.forename: Akihiko
authors.initials: A
authors.lastname: Tsuchida
mesh_terms: D001652:Bile Ducts / Q000000981:diagnostic imaging*; D002768:Choledochostomy / Q000379:methods*; D004322:Drainage / Q000379:methods*; D019160:Endosonography / Q000379:methods*; D006801:Humans; D041781:Jaundice, Obstructive / Q000000981:diagnostic imaging / Q000628:therapy*; D015203:Reproducibility of Results