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Notably, extracorporeal shock wave lithotripsy and electrohydraulic shock wave lithotripsy have improved the endoscopic stone removal rate in patients for whom pancreatic stone removal is difficult. Studies have reported the use of self\u2010expanding metal stents for stent placement for pancreatic duct stenosis and EUS\u2010guided pancreatic drainage for refractory pancreatic duct strictures. Furthermore, EUS\u2010guided drainage using a double\u2010pigtailed plastic stent has been performed for the management of symptomatic pancreatic fluid collection after acute pancreatitis. Recently, lumen\u2010apposing metal stents have led to advances in the treatment of walled\u2010off necrosis after acute pancreatitis. EUS\u2010guided biliary drainage is an alternative to refractory endoscopic biliary drainage and percutaneous transhepatic biliary drainage for the treatment of acute cholangitis. The placement of an inside stent followed by switching to uncovered self\u2010expanding metal stents in difficult\u2010to\u2010treat cases has been proposed for acute cholangitis by malignant biliary obstruction. Endoscopic transpapillary gallbladder drainage is an alternative to percutaneous transhepatic gallbladder drainage for severe and some cases of moderate acute cholecystitis. EUS\u2010guided gallbladder drainage has been reported as an alternative to percutaneous transhepatic gallbladder drainage and endoscopic transpapillary gallbladder drainage. 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