Korean J Radiol.  2012 Feb;13(Suppl 1):S74-S82. 10.3348/kjr.2012.13.S1.S74.

Endoscopic Ultrasound-Guided Biliary Drainage

  • 1University of Sao Paulo, Sao Paulo, SP-Brazil. eartifon@hotmail.com


To demonstrate a comprehensive review of published articles regarding endoscopic ultrasound (EUS)-guided biliary drainage.
Review of studies regarding EUS-guided biliary drainage including case reports, case series and previous reviews.
EUS-guided hepaticogastrostomy, coledochoduodenostomy and choledoantrostomy are advanced biliary and pancreatic endoscopy procedures, and together make up the echo-guided biliary drainage. Hepaticogastrostomy is indicated in cases of hilar obstruction, while the procedure of choice is the coledochoduodenostomy or choledochoantrostomy in distal lesions. Both procedures must be performed only after unsuccessful ERCPs. The indication of these procedures must be made under a multidisciplinary view while sharing information with the patient or legal guardian.
Hepaticogastrostomy and coledochoduodenostomy or choledochoantrostomy are feasible when performed by endoscopists with expertise in biliopancreatic endoscopy. Advanced echo-endoscopy should currently be performed under a rigorous protocol in educational institutions.


Biliary tract; Drainage; Endosonography; Gastrointestinal endoscopy; Obstructive jaundice

MeSH Terms

Bile Duct Diseases/*surgery/ultrasonography
Cholangiopancreatography, Endoscopic Retrograde
*Ultrasonography, Interventional


  • Fig. 1 Endoscopic ultrasound (EUS)-guided hepatico gastrostomy is demonstrated using step-by-step technique in which we can see EUS images with dilated IHD, puncture, cholangiography, guidewire placement, fistulization using needle-knife catheter, and deployment of partially covered self-expandable metal stent.

  • Fig. 2 Endoscopic ultrasound (EUS)-guided choledochoduodenostomy. It is demonstrated step-by-step technique in which we can see EUS images with dilated common bile duct, puncture, cholangiography, guidewire placement, fistulization using needle-knife catheter, deployment of partially covered self-expandable metal stent.


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