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World J Gastroenterol. Jan 21, 2015; 21(3): 820-828
Published online Jan 21, 2015. doi: 10.3748/wjg.v21.i3.820
Technical tips of endoscopic ultrasound-guided choledochoduodenostomy
Takeshi Ogura, Kazuhide Higuchi
Takeshi Ogura, Kazuhide Higuchi, Second Department of Internal Medicine, Osaka Medical College, Osaka 569-8686, Japan
Author contributions: Ogura T and Higuchi K equally contributed to this paper.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Takeshi Ogura, MD, PhD, Second Department of Internal Medicine, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka 569-8686, Japan. oguratakeshi0411@yahoo.co.jp
Telephone: +81-7-26831221 Fax: +81-7-26846532
Received: August 2, 2014
Peer-review started: August 2, 2014
First decision: August 27, 2014
Revised: September 12, 2014
Accepted: November 18, 2014
Article in press: November 19, 2014
Published online: January 21, 2015
Processing time: 171 Days and 10.5 Hours
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.

Keywords: Endoscopic ultrasound; Endoscopic ultrasound-guided choledochoduodenostomy; Endoscopic ultrasound-guided biliary drainage; Percutaneous transhepatic biliary drainage

Core tip: Endoscopic ultrasound-guided choledocoduodenostomy (EUS-CDS) is relatively well established as an alternative biliary drainage method. 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%. EUS-CDS may become the first choice of the biliary tract drainage procedure in the local cases such as poor prognosis, the contraindication of percutaneous transhepatic biliary drainage.