title: Endoscopic ultrasound-guided biliary interventions: an update on recent developments.
abstract: OBJECTIVE
  Endoscopic ultrasound (EUS)-guided biliary drainage procedures can be utilized in patients with biliary obstruction and incomplete drainage with prior interventions, in those whose ampulla is inaccessible (i.e. from surgically altered anatomy and malignant luminal obstruction), or in those who failed bile duct cannulation during endoscopic retrograde cholangiopancreatography. Improved techniques and accessories have streamlined these procedures; however, further investigation is required. The purpose of this review is to provide the highlights of the most recent literature on EUS-guided biliary drainage.
  
  
  RESULTS
  Recent literature has demonstrated the effectiveness and safety of EUS-guided gallbladder drainage, both as a primary intervention in patients with cholecystitis who are unfit for urgent surgical intervention and as a secondary intervention to internalize biliary drainage after initial placement of a cholecystostomy catheter. EUS-guided bile duct drainage can be performed using various techniques. The optimal technique requires further study and may vary by clinical scenario.
  
  
  CONCLUSIONS
  The role of EUS-guided biliary drainage continues to evolve. The most recent literature has attempted to clarify the optimal strategies and indications for employing the various EUS-guided biliary drainage techniques.
authors.affiliation: aDivision of Gastroenterology, University of Michigan, Ann Arbor, MichiganbDivision of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA.
authors.forename: Ryan
authors.initials: R
authors.lastname: Law
authors.forename: Todd H
authors.initials: TH
authors.lastname: Baron
mesh_terms: D001652:Bile Ducts / Q000000981:diagnostic imaging* / Q000601:surgery; D002779:Cholestasis / Q000628:therapy*; D004322:Drainage; D019160:Endosonography; D005704:Gallbladder / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D018084:Ultrasonography, Interventional