title: Endoscopy Ultra- Sonography -guided biliary drainage in the surgical -endoscopy era.
abstract: BACKGROUND
  US-guided hepatico - gastrostomy, choledocho-duodenostomy and choledocho-antrostomy are advanced procedures on biliary and pancreatic endoscopy and together make up the echo-guided biliary drainage. Hepatico - gastrostomy is indicated in cases of hiliar obstruction, while the procedure of choice is choledocho - duodenostomy in distal lesions. Both procedures must be done only after unsuccessful ERCP.
  
  
  OBJECTIVE
  To clarify to the readers about indication of these procedures, they must be made under a multidisciplinary view while sharing information with the patient or legal guardian.
  
  
  METHODS
  All series cases report and selected cohort studies were selected according to the DDTS system in which key words were EUS biliary drainage, choledocho-duodenostomy, hepatico-gastrostomy, EUS, palliation and pancreatic biliary advanced cancer.
  
  
  RESULTS
  Separately it was stated definition on the EUS biliary drainage procedures and it includes the techniques details and critical analysis.
  
  
  CONCLUSIONS
  Hepatico- gastrostomy and Choledocho- duodenostomy are feasible when performed by endoscopists with expertise in bilio pancreatic endoscopy and advanced echo-endoscopy and should be performed currently under rigorous protocol in educational institutions.
authors.affiliation: GI Endoscopy Service, Department of Surgery,University of Sao Paulo-Sao Paulo, Brazil.
authors.forename: Everson L A
authors.initials: EL
authors.lastname: Artifon
authors.forename: Jose
authors.initials: J
authors.lastname: Pinhata Otoch
authors.forename: Alejandro
authors.initials: A
authors.lastname: Yábar
authors.forename: Luiz F
authors.initials: LF
authors.lastname: Poli-de-Figueiredo
authors.forename: Paulo
authors.initials: P
authors.lastname: Sakai
authors.forename: Samir
authors.initials: S
authors.lastname: Rasslan
mesh_terms: D000714:Anastomosis, Surgical; D001649:Bile Duct Diseases / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic / Q000601:surgery; D002768:Choledochostomy / Q000295:instrumentation / Q000379:methods*; D004322:Drainage / Q000295:instrumentation / Q000379:methods*; D019160:Endosonography / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D013270:Stomach / Q000601:surgery; D018084:Ultrasonography, Interventional / Q000295:instrumentation / Q000379:methods*