Endoscopic ultrasound-guided biliary drainage: A change in paradigm?

Table 1 Summary of trials comparing Endoscopic ultrasound-guided biliary drainage to endoscopic retrograde cholangiopancreatography in distal malignant biliary obstruction

Authors	Yr	Study type patients (n)	Type of EUS-BD/ stent used	Technical success (%) EUS-BD/ERCP (P-value)	Functional or clinical success (%) EUS-BD/ERCP (P-value)	Procedure time (min) BD/ERCP (P-value)	AE (%) BD/ERCP (P-value); PPP (%) EUS-BD/ERCP (P-value)	Stent dysfunction (%)EUS-BD/ERCP (P-value)	Re-intervention (%) EUS-BD/ERCP (P-value)
Kawakubo et al[25]	2016	Single center, retrospective cohort study (82)	EUS-CDS/ PCSEMS	-	96.2/98.2 (0.54)	Mean 19.7/30.2 (﹤0.01)	26.9/35.7 (0.46); 0/16.1 (0.50)	-	20/12.7 (0.50)
Dhir et al[26]	2015	Multicenter, retrospective (208)	EUS-CDS + EUS-HGS/ FC +UCSEMS	93.26/94.23 (1.00)	89.42/91.34 (0.814)	Median 35.95/30.1 (0.05)	8.65/8.65 (1.00); 0/4.8 (0.59)	-	-
Nakai et al[27]	2018	Multicenter, prospective (34)	EUS-CDS/ PC + FCSEMS	97	100	Median 25/52 (﹤0.01)	15/24	29/36 (0.78)	-
Park et al[28]	2018	Single center, prospective, RCT (30)	EUS-CDS/ PCSEMS	92.8/100 (1.00)	92.8/100 (1.00)	Median 43/31 (0.2)	0/0 (1.00)	15.4/30.8 (0.65)	-
Bang et al[29]	2018	Single center, prospective, RCT (67)	EUS-CDS/ FCSEMS	90.9/94.1 (0.67)	97/91.2 (0.61)	Median 25/21 (0.173)	21.2/14.7 (0.49)	1/1 (0.97)	3/2.9 (0.99)
Paik et al[30]	2018	Multicenter, prospective RCT (125)	Distal MBO/ EUS-CDS, EUS-HGS/hybrid PCSEMS	93.8/90.2 (0.003 for non-inferiority margin 10%)	90/94.5 (0.49)	Median 5/11 (﹤0.01)	Early AE 6.3/19.7 (0.03); 0/14.8 (0.001)	-	15.6/42.6 (0.001) (stent patency 85.1 vs 48.9, P = 0.001)

EUS-BD: Endoscopic ultrasound-guided biliary drainage; EUS-CDS: EUS-guided choledocoduodenostomy; EUS-HGS: EUS-guided hepaticogastrostomy; AE: Adverse events; PPP: Post procedural pancreatitis; SEMS: Self-expandable metal stents; FCSEMS: Fully-covered SEMS; PCSEMS: Partially-covered SEMS; UCSEMS: Uncovered SEMS; ERCP: endoscopic retrograde cholangiopancreatography.