Endoscopic ultrasound-guided drainage of the biliary system: Techniques, indications and future perspectives

Figure 1 Schematic and case illustration of the choledochoduodenostomy (A) and the hepaticogastrostomy (B). Patient A had a distal bile duct obstruction due to a locally advanced pancreatic head carcinoma. Patient B had a large perihilar metastasis of a small cell lung carcinoma with a complete obstruction of the proximal common bile duct but preserved left-right intrahepatic bile duct communication. The choledochoduodenostomy can be combined with a duodenal stent or an endoscopic gastrojejunostomy if indicated. Adapted from Paik et al[5].