Jintao Guo, Shengjing Hospital of China Medical University
Marc Giovannini, Institute Paoli-Calmettes
Anand V. Sahai, Université de Montréal
Adrian Saftoiu, University of Medicine and Pharmacy, Craiova
Christoph F. Dietrich, Caritas Hospital, Bad Mergentheim
Erwin Santo, Tel-Aviv Sourasky Medical Center
Pietro Fusaroli, University of Bologna
Ali Siddiqui, Thomas Jefferson UniversityFollow
Manoop S. Bhutani, The University of Texas MD Anderson Cancer Center
Anthony Yuen Bun Teoh, Chinese University of Hong Kong
Atsushi Irisawa, Dokkyo Medical University
Brenda Lucia Arturo Arias, Universidad de Caldas
Chalapathi Rao Achanta, Queen's NRI Hospital, Visakhapatnam
Christian Jenssen, Krankenhaus Märkisch Oderland Strausberg
Dong-Wan Seo, University of Ulsan College of Medicine
Douglas G. Adler, University of Utah School of Medicine
Evangelos Kalaitzakis, Copenhagen University Hospital Herlev
Everson Artifon, University of Sao Paulo, Brazil
Fumihide Itokawa, Tokyo Adventist Hospital
Jan Werner Poley, Erasmus MC University Medical Center Rotterdam
Girish Mishra, Wake Forest Baptist Health
Khek Yu Ho, National University of Singapore
Hsiu-Po Wang, National Taiwan University Hospital
Hussein Hassan Okasha, Cairo University
Jesse Lachter, Rambam Health Care Campus, Haifa
Juan J. Vila, Complejo Hospitalario de Navarra
Julio Iglesias-Garcia, University Hospital of Santiago de Compostela
Kenji Yamao, Aichi Cancer Center Hospital
Kenjiro Yasuda, Kyoto Second Red Cross Hospital
Kensuke Kubota, Yokohama City University School of Medicine
Laurent Palazzo, Trocadero Clinic, Paris
Luis Carlos Sabbagh, Clinica Reina Sofia, Bogota
Malay Sharma, Jaswant Rai Specialty Hospital, Meerut, India
Mitsuhiro Kida, Kitasato University East Hospital
Mohamed El-Nady, Cairo University
Nam Q. Nguyen, Royal Adelaide Hospital
Peter Vilmann, Copenhagen University Hospital Herlev
Pramod Kumar Garg, All India Institute of Medical Sciences, New Delhi
Praveer Rai, All India Institute of Medical Sciences, New Delhi
Shuntaro Mukai, Tokyo Medical University
Silvia Carrara, Humanitas Research Hospital, Milan
Sreeram Parupudi, Texas Tech University Health Sciences Center
Subbaramiah Sridhar, Augusta University
Sundeep Lakhtakia, Asian Institute of Gastroenterology
Surinder S Rana, Postgraduate Institute of Medical Education and Research, Chandigarh
Takeshi Ogura, Osaka Medical College
Todd H. Baron, University of North Carolina at Chapel Hill
Vinay Dhir, SL Raheja Hospital, Mumbai
Siyu Sun, Shengjing Hospital of China Medical University

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This article has been peer reviewed. It is the author’s final published version in Endoscopic Ultrasound, Volume 7, Issue 6, November-December 2018, Pages 356-365.

The published version is available at Copyright © Guo et al.


Background and Objectives: EUS-guided biliary drainage (EUS-BD) was shown to be useful for malignant biliary obstruction (MBO). However, there is lack of consensus on how EUS-BD should be performed.

Methods: This was a worldwide multi-institutional survey among members of the International Society of EUS conducted in February 2018. The survey consisted of 10 questions related to the practice of EUS-BD.

Results: Forty-six endoscopists of them completed the survey. The majority of endoscopists felt that EUS-BD could replace percutaneous transhepatic biliary drainage after failure of ERCP. Among all EUS-BD methods, the rendezvous stenting technique should be the first choice. Self-expandable metal stents (SEMSs) were recommended by most endoscopists. For EUS-guided hepaticogastrostomy (HGS), superiority of partially-covered SEMS over fully-covered SEMS was not in agreement. 6-Fr cystotomes were recommended for fistula creation. During the HGS approach, longer SEMS (8 or 10 cm) was recommended. During the choledochoduodenostomy approach, 6-cm SEMS was recommended. During the intrahepatic (IH) approach, the IH segment 3 was recommended.

Conclusion: This is the first worldwide survey on the practice of EUS-BD for MBO. There were wide variations in practice, and randomized studies are urgently needed to establish the best approach for the management of this condition.

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