Updated approaches to endoscopic biliary drainage

Endoscopic biliary drainage remains the cornerstone of managing malignant and benign biliary obstructions. Over the past decade, significant advancements in endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS)-guided techniques have revolutionized therapeutic options, offering minimally invasive solutions with improved efficacy and safety. This lecture will provide an up-to-date review of contemporary endoscopic approaches to biliary drainage, focusing on:
- ERCP-based techniques, including the latest innovations in stent design and strategies for challenging cases
- EUS-guided biliary drainage (EUS-BD), covering transmural (choledochoduodenostomy, hepaticogastrostomy) and rendezvous procedures, with emphasis on patient selection, technical nuances, and complication mitigation.
- Comparative insights on the roles of ERCP and EUS-BD, supported by recent evidence and consensus guidelines.
As endoscopic techniques continue to advance, ERCP and EUS-BD offer complementary, minimally invasive solutions for biliary drainage. This lecture will equip practitioners with evidence-based strategies to optimize outcomes in complex biliary obstructions.