Endoscopic ultrasonography-guided biliary drainage.
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.
Itoi
Takao
T
Department of Gastroenterology and Hepatology, Tokyo Medical University, Shinjuku-ku, Nishishinjuku 6-7-1, Tokyo, Japan. itoi@tokyo-med.ac.jp
Sofuni
Atsushi
A
Itokawa
Fumihide
F
Tsuchiya
Takayoshi
T
Kurihara
Toshio
T
Ishii
Kentaro
K
Tsuji
Shujiro
S
Ikeuchi
Nobuhito
N
Umeda
Junko
J
Moriyasu
Fuminori
F
Tsuchida
Akihiko
A
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