Endoscopic Approaches to the Management of Biliary Tract Pathology: The Use of Therapeutic Endoscopic Ultrasound

Endoscopic ultrasound–guided biliary drainage (EUS-BD) procedures aid in the treatment of biliary diseases and can be considered in the setting of failed conventional endoscopic retrograde cholangiopancreatography, surgically altered gastrointestinal or biliary anatomy with an inaccessible major papilla, malignant obstruction precluding biliary access, or a contraindication to percutaneous biliary access. Although device innovations and technical improvements continue to advance the field of therapeutic EUS, further investigations are required. The purpose of this review is to highlight recent literature on the indications, techniques, capabilities, and outcomes of EUS-BD. Recent literature has demonstrated that EUS-BD is a safe and effective treatment option in the management of biliary diseases. Current studies have assessed the various EUS-BD techniques and have attempted to clarify the optimal treatment algorithm for those with complex biliary pathologies.