Endoscopic ultrasound guided biliary drainage: literature review

Mantas Markauskas1

1Vilnius City Clinical Hospital, Vilnius, Lithuania


Background. The first echoendoscope was introduced only as diagnostic tool in 1980 and it was mainly used to diagnose tumors, located in mediastinum, pancreas, liver or biliary tree. Therapeutic procedures using endoscopic ultrasound became possible only in 1991, when first linear echoendoscope and needle compatible with it were introduced. During past two decades echoendoscope and its accessories were improved, therefore complex therapeutic procedures using endoscopic ultrasound, such as gallbladder and biliary drainage, pancreatic duct and peripancreatic fluid drainage, pancreatic tumor ablation, brachytherapy, celiac plexus neurolysis, gastroenterostomy and many others, became possible.

Aim. To discuss the recent literature describing endoscopic ultrasound guided biliary drainage. Procedure is discussed in terms of its indications, technique, results and adverse events.

Methods. The literature search was performed in the PubMed database by entering relevant keywords in various combinations into the regular and advanced search fields, as well as using the bibliographies of the articles found. A total of 38 publications were found during the review, with 24 scientific publications based on the inclusion criteria.

Conclusion. Literature indicates that endoscopic ultrasound guided biliary drainage can be safely performed on patients with biliary obstruction after failed endoscopic retrograde cholangiopancreatography. Present studies allow to conclude that endoscopic ultrasound guided biliary drainage is safe and efficient. However, in order to confirm endoscopic ultrasound guided biliary drainage as first-line treatment on patients with biliary obstruction after failed endoscopic retrograde cholangiopancreatography, further large prospective multicenter studies are needed.

Keywords: endoscopic ultrasound, therapeutic procedures, biliary drainage.