title: Technical tips of endoscopic ultrasound-guided choledochoduodenostomy.
abstract: Endoscopic ultrasound (EUS) is clinically useful not only as a diagnostic tool during EUS-guided fine needle aspiration, but also during interventional EUS. EUS-guided biliary drainage has been developed and performed by experienced endoscopists. EUS-guided choledocoduodenostomy (EUS-CDS) is relatively well established as an alternative biliary drainage method for biliary decompression in patients with biliary obstruction. The reported technical success rate of EUS-CDS ranges from 50% to 100%, and the clinical success rate ranges from 92% to 100%. Further, the over-all technical success rate was 93%, and clinical success rate was 98%. Based on the currently available literature, the overall adverse event rate for EUS-CDS is 16%. The data on the cumulative technical and clinical success rate for EUS-CDS is promising. However, EUS-CDS can still lead to several problems, so techniques or devices that are more feasible and safe need to be established. EUS-CDS has the potential to become a first-line biliary drainage procedure, although standardizing the technique in multicenter clinical trials and comparisons with endoscopic biliary drainage by randomized clinical trials are still needed.
authors.affiliation: Takeshi Ogura, Kazuhide Higuchi, Second Department of Internal Medicine, Osaka Medical College, Osaka 569-8686, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ogura
authors.affiliation: Takeshi Ogura, Kazuhide Higuchi, Second Department of Internal Medicine, Osaka Medical College, Osaka 569-8686, Japan.
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Higuchi
mesh_terms: D002768:Choledochostomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D002779:Cholestasis / Q000175:diagnosis / Q000628:therapy*; D003664:Decompression / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D004322:Drainage / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D020776:Endoscopes, Gastrointestinal; D016145:Endoscopy, Digestive System; D019160:Endosonography / Q000295:instrumentation; D004867:Equipment Design; D006801:Humans; D018579:Patient Selection; D011237:Predictive Value of Tests; D012307:Risk Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000295:instrumentation
keywords: Endoscopic ultrasound; Endoscopic ultrasound-guided biliary drainage; Endoscopic ultrasound-guided choledochoduodenostomy; Percutaneous transhepatic biliary drainage