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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Jan 16, 2015; 7(1): 37-44
Published online Jan 16, 2015. doi: 10.4253/wjge.v7.i1.37
Endoscopic ultrasound-guided biliary drainage as an alternative to percutaneous drainage and surgical bypass
Varayu Prachayakul, Pitulak Aswakul
Varayu Prachayakul, Siriraj GI Endoscopy Center, Division of Gastroenterology, Department of Internal Medicine, Siriraj Hospital, Faculty of Medicine, Mahidol University, Bangkok 10700, Thailand
Pitulak Aswakul, Liver and Digestive Institute, Samitivej Sukhumvit Hospital, Bangkok 10120, Thailand
Author contributions: Prachayakul V designed the concept; Prachayakul V and Aswakul P reviewed that literature, wrote and revised the manuscript.
Conflict-of-interest: Prachayakul V and Aswakul P declared no conflict of interest regarded this article.
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: Varayu Prachayakul, MD, Siriraj GI Endoscopy Center, Division of Gastroenterology Department of Internal Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand. kaiyjr@gmail.com
Telephone: +66-818-654646 Fax: +66-241-15013
Received: September 26, 2014
Peer-review started: September 28, 2014
First decision: November 19, 2014
Revised: November 21, 2014
Accepted: December 16, 2014
Article in press: December 17, 2014
Published online: January 16, 2015
Processing time: 111 Days and 14 Hours
Abstract

Endoscopic retrograde cholangiopancreatography had been a treatment modality of choice for both benign and malignant biliary tract obstruction for more than half century, with a very high clinical success rate and low complications. But in certain circumstances, such as advanced and locally advanced pancreatobiliary malignancies (pancreatic cancer, cholangiocarcinoma, ampullary tumor) and tight benign strictures, endoscopic retrograde cholangiopancreatography (ERCP) fails. Up to this point, the only alternative interventions for these conditions were percutaneous transhepatic biliary drainage or surgery. Endoscopic ultrasound guided interventions was introduced for a couple decades with the better visualization and achievement of the pancreatobiliary tract. And it’s still in the process of ongoing development. The inventions of new techniques and accessories lead to more feasibility of high-ended procedures. Endoscopic ultrasound guided biliary drainage was a novel treatment modality for the patient who failed ERCP with the less invasive technique comparing to surgical bypass. The technical and clinical success was high with acceptable complications. Regarded the ability to drain the biliary tract internally without an exploratory laparotomy, this treatment modality became a very interesting procedures for many endosonographers, worldwide, in a short period. We have reviewed the literature and suggest that endoscopic ultrasound-guided biliary drainage is also an option, and one with a high probability of success, for biliary drainage in the patients who failed conventional endoscopic drainage.

Keywords: Endoscopic ultrasound; Endoscopic ultrasound; Biliary drainage; Choledochoduodenostomy; Hepaticogastrostomy; Technique

Core tip: Failure of endoscopic retrograde cholangiopancreatography occurs in 5%-10% of the cases from many etiologies. However, there are few alternative options for biliary drainage up to the present time. Percutaneous biliary drainage and surgical bypass have their own drawbacks. Endoscopic ultrasound guided biliary drainage (EUS-BD) is a new platform with a very high technical and clinical success rate with an acceptable complications. This review focused on the techniques, instruments including tips and tricks of this treatment modality. EUS-BD would become another alternative options for biliary drainage for both benign and malignant conditions in the future.