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EUS Access to the Biliary Tree

  • PANCREAS AND BILIARY TRACT (O HALUSZKA, SECTION EDITOR)
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Abstract

EUS-guided biliary access procedures can target the gallbladder or the bile duct for drainage in selected cases. EUS-guided gallbladder drainage offers comparable results to percutaneous cholecystostomy in high-surgical risk patients with acute cholecystitis refractory to medical treatment. The procedure is not yet widely available. Novel lumen-apposing stents may improve long-term outcomes, resulting in rapid dissemination. EUS access to the bile duct is coupled with ERCP techniques into a hybrid procedure, endosono-cholangiopancreatography (ESCP). ESCP admits six variant approaches to bile duct drainage based on the combination of two access routes (intrahepatic and extrahepatic) with three drainage routes: transmural, retrograde transpapillary and antegrade transpapillary. A thousand ESCP cases have been reported to date with good outcomes. When the expertise is available, ESCP is increasingly replacing percutaneous transhepatic biliary drainage to provide biliary drainage in patients in whom ERCP is not feasible, predominantly in the setting of palliation, but not limited to it.

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Conflict of Interest

Manuel Perez-Miranda and Carlos De la Serna-Higuera declare that they have no conflict of interest

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Gastroenterology Department, Hospital Universitario Rio Hortega, Av. Dulzaina,2, 47012, Valladolid, Spain

    Manuel Perez-Miranda & Carlos De la Serna-Higuera

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  1. Manuel Perez-Miranda
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  2. Carlos De la Serna-Higuera
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Corresponding author

Correspondence to Manuel Perez-Miranda.

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This article is part of the Topical Collection on Pancreas and Biliary Tract

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Perez-Miranda, M., De la Serna-Higuera, C. EUS Access to the Biliary Tree. Curr Gastroenterol Rep 15, 349 (2013). https://doi.org/10.1007/s11894-013-0349-x

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