Evolving as a minimally invasive access method for the biliary tract, EUS-BD has been assessed so far in two endoscopic settings: EUS hepaticogastrostomy and EUS-CDS (7).
(7.) Ogura T, Chiba Y, Masuda D, et al Comparison of the clinical impact of endoscopic ultrasound-guided choledochoduodenostomy and hepaticogastrostomy for bile duct obstruction with duodenal obstruction Endoscopy 2016, 48 156-63
(9.) Uemura RS, Khan MA, Otoch JP, Kahaleh M, Montero EF, Artifon ELA EUS-guided Choledochoduodenostomy Versus Hepaticogastrostomy A Systematic Review and Meta-Analysis J Clin Gastroenterol 2017 [Epub ahead of print]
Additional risk factors for ERCP-related hemobilia which should be mentioned are variant anatomy, especially anomalous location of the ampulla, aggressive biliary balloon dilation or intraductal biopsying, vascular anomalies (e.g., associated with hereditary hemorrhagic telangiectasia), and transbiliary ductal drainage procedures (e.g., EUS-guided choledochoduodenostomy and hepaticogastrostomy) [8, 21-24].
EUS-BD techniques include EUS-guided choledochoduodenostomy (EUS-CDS) and EUS-guided hepaticogastrostomy (EUS-HGS).
The direct access technique includes EUS-guided choledochoduodenostomy (EUS-CDS), EUS-guided hepaticogastrostomy (EUS-HGS), and EUS-guided gallbladder drainage (EUS-GbD) [8, 9].
The clinical success rates for the choledochoduodenostomy approach and the hepaticogastrostomy approach were 78.2% and 100%, respectively.
Ratanachu-Ek, "Endoscopic ultrasound-guided hepaticogastrostomy for advanced cholangiocarcinoma after failed stenting by endoscopic retrograde cholangiopancreatography," Asian Journal of Surgery, vol.
Higuchi, "Technical tips for endoscopic ultrasound-guided hepaticogastrostomy," World Journal of Gastroenterology, vol.
As for transluminal biliary drainage, EUS-guided hepaticogastrostomy (EUS-HGS) was performed in patients with proximal biliary obstruction, surgically altered anatomy, or duodenal obstruction, while EUS-guided choledochoduodenostomy (EUS-CDS) was reserved for patients with middle or distal biliary obstruction.
Choi et al., "Simplified fistula dilation technique and modified stent deployment maneuver for EUS-guided hepaticogastrostomy," World Journal of Gastroenterology, vol.
Otoch, "Hepaticogastrostomy or choledochoduodenostomy for distal malignant biliary obstruction after failed ERCP: is there any difference?" Gastrointestinal Endoscopy, vol.