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Year : 2021  |  Volume : 10  |  Issue : 3  |  Page : 154-160

EUS-guided biliary drainage for malignant hilar biliary obstruction: A concise review

1 Department of Digestive Diseases and Clinical Nutrition, Tata Memorial Hospital, Mumbai, Maharashtra, India
2 Institute of Digestive and Liver Care, SL Raheja Hospital, Mumbai, Maharashtra, India

Correspondence Address:
Dr. Sridhar Sundaram
Department of Digestive Diseases and Clinical Nutrition, Tata Memorial Hospital, Dr. E Borges Road, Mumbai - 400 012, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/EUS-D-21-00004

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EUS-guided biliary drainage (EUS-BD) has emerged as an alternative to ERCP for distal biliary obstruction in expert hands. Various routes for EUS-guided access in distal biliary obstruction include EUS choledochoduodenostomy, EUS-guided rendezvous, and EUS-antegrade (EUS-AG) stent placement. While percutaneous transhepatic biliary drainage and ERCP are established modalities in management of malignant hilar biliary obstruction, the role of EUS-BD is emerging. Various methods of drainage in hilar obstruction include EUS hepaticogastrostomy, EUS hepaticoduodenostomy, EUS-guided bridging stent placement, and combined ERCP and EUS-guided biliary drainage. In this review, we discuss the role of EUS-BD in malignant hilar biliary obstruction with the currently available evidence, along with the limitations and challenges to the use of this modality in management of these patients.

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