title: Endoscopic ultrasonographic access and drainage of the common bile duct.
abstract: Endoscopic retrograde cholangiopancreatography (ERCP) is currently the standard of care for biliary drainage. In the hands of experienced endoscopists, conventional ERCP has a failed cannulation rate of 3% to 5%. Failures have traditionally been referred for either percutaneous transhepatic biliary drainage (PTBD) or surgery. Both PTBD and surgery have higher than desirable complication rates. Endoscopic ultrasound-guided biliary drainage (EUS-BD) is a novel and attractive alternative after failed ERCP. Many groups have reported on the feasibility, efficacy, and safety of this technique. This article reviews the indications and technique currently practiced in EUS-BD, including EUS-guided rendezvous, EUS-guided choledochoduodenostomy, and EUS-guided hepaticogastrostomy.
authors.affiliation: Division of Gastroenterology & Hepatology, Weill Cornell Medical College, New York, NY 10021, USA.
authors.forename: Savreet
authors.initials: S
authors.lastname: Sarkaria
authors.forename: Subha
authors.initials: S
authors.lastname: Sundararajan
authors.forename: Michel
authors.initials: M
authors.lastname: Kahaleh
mesh_terms: D002760:Cholangiopancreatography, Endoscopic Retrograde; D002768:Choledochostomy / Q000379:methods; D003135:Common Bile Duct / Q000000981:diagnostic imaging*; D004322:Drainage / Q000009:adverse effects / Q000379:methods*; D019160:Endosonography; D006801:Humans; D015607:Stents; D017211:Treatment Failure; D018084:Ultrasonography, Interventional / Q000009:adverse effects / Q000379:methods*