Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 28, 2015; 21(4): 1049-1052
Published online Jan 28, 2015. doi: 10.3748/wjg.v21.i4.1049
Does endoscopic ultrasound-guided biliary drainage really have clinical impact?
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 solely contributed to this paper.
Conflict-of-interest: No potential conflicts of interest relevant to this article were reported.
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: +81-726-831221 Fax: +81-726-846532
Received: November 6, 2014
Peer-review started: November 7, 2014
First decision: November 26, 2014
Revised: November 29, 2014
Accepted: December 20, 2014
Article in press: December 22, 2014
Published online: January 28, 2015
Abstract

The well established, gold standard method for treatment of obstructive jaundice involves biliary drainage under endoscopic retrograde cholangiopancreatography (ERCP) performed by pancreatobiliary endoscopists. Recently, interventions using endoscopic ultrasound (EUS) have been developed not only for obtaining cytological and histological diagnosis, but also for biliary drainage as alternative method. EUS-guided biliary drainage (EUS-BD) was first reported by Giovannini et al. EUS-BD broadly includes EUS-guided rendezvous technique, EUS-guided choledochoduodenostomy, and EUS-guided hepaticogastrostomy. More recently, EUS-guided antegrade stenting and EUS-guided gallbladder drainage have also been reported. many case reports, series, and retrospective studies on EUS-BD have been reported. However, because prospective studies and comparisons between the different biliary drainage methods have not been reported, the technical success, functional success, adverse events, and stent patency with long-term follow up of EUS-BD are still unclear. Therefore, prospective, randomized controlled studies addressing these issues are needed. Despite this, EUS-BD undoubtedly is clinically useful as an alternative biliary drainage method. EUS-BD has the potential to be a first-line biliary drainage method instead of ERCP if results of clinical trials are favorable and the technique is simplified.

Keywords: Endoscopic ultrasound, Endoscopic ultrasound-guided biliary drainage, Endoscopic ultrasound-guided hepaticogastrostomy, Endoscopic ultrasound-guided choledochoduodenostomy, Endoscopic ultrasound-guided antegrade stenting, Endoscopic ultrasound-guided gallbladder drainage

Core tip: To date, many case reports, series, and retrospective studies on EUS-guided biliary drainage (EUS-BD) have been reported. However, because prospective studies and comparisons between the different biliary drainage methods have not been reported, the technical success, functional success, adverse events, and stent patency with long-term follow up of EUS-BD are still unclear. Therefore, prospective, randomized controlled studies addressing these issues are needed. Despite this, EUS-BD undoubtedly is clinically useful. EUS-BD has the potential to be a first-line biliary drainage method instead of endoscopic retrograde cholangiopancreatography if results of clinical trials are favorable and the technique is simplified.