Results of EUS Transmural Biliary Drainage

Endoscopic retrograde cholangiopancreatography (ERCP) for biliary drainage is not always successful due to alterations of the anatomy or because of the inability to access the papilla. Percutaneous transhepatic biliary drainage (PTBD) was traditionally considered the only alternative in these cases. Endoscopic ultrasonography-guided biliary drainage (EUS-BD) represents a valid alternative to PTBD when ERCP fails. According to the site of access to the biliary tree, two kinds of approaches may be recognized: the intrahepatic and the extrahepatic one.