title: Endoscopic ultrasound-guided biliary drainage.
abstract: OBJECTIVE
  To demonstrate a comprehensive review of published articles regarding endoscopic ultrasound (EUS)-guided biliary drainage.
  
  
  METHODS
  Review of studies regarding EUS-guided biliary drainage including case reports, case series and previous reviews.
  
  
  RESULTS
  EUS-guided hepaticogastrostomy, coledochoduodenostomy and choledoantrostomy are advanced biliary and pancreatic endoscopy procedures, and together make up the echo-guided biliary drainage. Hepaticogastrostomy is indicated in cases of hilar obstruction, while the procedure of choice is the coledochoduodenostomy or choledochoantrostomy in distal lesions. Both procedures must be performed only after unsuccessful ERCPs. The indication of these procedures must be made under a multidisciplinary view while sharing information with the patient or legal guardian.
  
  
  CONCLUSIONS
  Hepaticogastrostomy and coledochoduodenostomy or choledochoantrostomy are feasible when performed by endoscopists with expertise in biliopancreatic endoscopy. Advanced echo-endoscopy should currently be performed under a rigorous protocol in educational institutions.
authors.affiliation: University of São Paulo Medical School, São Paulo, SP-Brazil. eartifon@hotmail.com
authors.forename: Everson L A
authors.initials: EL
authors.lastname: Artifon
authors.forename: Flávio C
authors.initials: FC
authors.lastname: Ferreira
authors.forename: Paulo
authors.initials: P
authors.lastname: Sakai
mesh_terms: D001649:Bile Duct Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002768:Choledochostomy / Q000379:methods; D004322:Drainage / Q000379:methods*; D019160:Endosonography / Q000379:methods*; D005774:Gastrostomy / Q000379:methods; D006801:Humans; D018084:Ultrasonography, Interventional