Division of Gastroenterology & Hepatology, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, MD 21201, USA.
Hackensack University Medical Center, Hackensack, NJ, USA.
Gastrointest Endosc Clin N Am. 2024 Jul;34(3):487-500. doi: 10.1016/j.giec.2023.12.002. Epub 2024 Jan 9.
Endoscopic ultrasound (EUS)-guided biliary drainage (BD) is a minimally invasive procedure that allows for biliary access when conventional endoscopic retrograde cholangiopancreatography (ERCP) is unsuccessful. The technique can be divided based on biliary access route: intrahepatic or extrahepatic, as well as on stenting approach: rendezvous approach (EUS-RV), antegrade placement, or transluminal (intra or extra hepatic) placement. There is no clear consensus on which approach is superior. Compared to percutaneous transhepatic biliary drainage, EUS-BD offers lower rates of adverse events without the need for an external drain. Compared to conventional ERCP, EUS-BD shows comparable, and in some cases superior, outcomes related to technical success, clinical success, and adverse events.
内镜超声（EUS）引导下胆道引流（BD）是一种微创程序，当常规内镜逆行胰胆管造影（ERCP）不成功时，可通过该程序进行胆道介入。根据胆道介入途径，该技术可分为经肝内或经肝外途径，以及支架置入途径：会师途径（EUS-RV）、顺行放置或经腔内（肝内或肝外）放置。目前尚无哪种方法更具优势的明确共识。与经皮经肝胆道引流相比，EUS-BD 具有较低的不良事件发生率，且无需外部引流。与常规 ERCP 相比，EUS-BD 在技术成功率、临床成功率和不良事件方面具有相当或在某些情况下更优的结果。
