{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:36:08Z","timestamp":1787027768553,"version":"build-2736575974"},"reference-count":82,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T00:00:00Z","timestamp":1761350400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>The indications for biliary drainage in cases of pancreatic head tumors with biliary obstruction are well established. ERCP with stent placement has long been the gold standard technique, outperforming surgery or percutaneous drainage. However, in cases of distal malignant biliary obstruction, ERCP becomes more complex, increasing the risk of complications. The advent of therapeutic endoscopic ultrasound (EUS), particularly EUS\u2013choledochoduodenostomy (EUS-CDS) and EUS\u2013hepaticogastrostomy (EUS-HGS), has transformed the management of distal malignant biliary obstruction in the case of pancreatic cancer. EUS-CDS creates communication between the duodenum and the common bile duct. Lumen-apposing metal stents (LAMSs) simplify the procedure, offering high technical and clinical success rates and making the technique easier to perform. Nevertheless, long-term dysfunction rates remain high, necessitating careful definition of procedural indications. EUS-HGS, a more complex technique, connects dilated left bile ducts to the stomach and requires advanced expertise; it is associated with a higher rate of complications. However, its clinical efficacy and technical success are comparable to those of EUS-CDS, and it is the preferred technique in cases of duodenal obstruction or altered anatomy. European and American guidelines currently position EUS-guided biliary drainage (EUS-BD) as a second-line approach after ERCP failure or when ERCP is not feasible, but there is a growing trend toward earlier use. Other techniques are emerging, such as EUS-guided gallbladder drainage (EUS-GBD) and combining EUS-HGS with antegrade stenting, offering valuable alternatives when conventional techniques fail or are inaccessible.<\/jats:p>","DOI":"10.3390\/cancers17213428","type":"journal-article","created":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T13:59:36Z","timestamp":1761659976000},"page":"3428","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Advances in EUS-Guided Biliary Drainage for the Management of Pancreatic Cancer"],"prefix":"10.3390","volume":"17","author":[{"given":"Thomas","family":"Lambin","sequence":"first","affiliation":[{"name":"Digestive Endoscopy Unit, H\u00f4pital Priv\u00e9 Jean Mermoz, Ramsay-Sant\u00e9, 69008 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Leblanc","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Unit, H\u00f4pital Priv\u00e9 Jean Mermoz, Ramsay-Sant\u00e9, 69008 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertrand","family":"Napol\u00e9on","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Unit, H\u00f4pital Priv\u00e9 Jean Mermoz, Ramsay-Sant\u00e9, 69008 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1055\/a-0659-9864","article-title":"Endoscopic Biliary Stenting: Indications, Choice of Stents, and Results: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline\u2014Updated October 2017","volume":"50","author":"Dumonceau","year":"2018","journal-title":"Endoscopy"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/j.dld.2021.07.010","article-title":"Difficult Biliary Cannulation in Patients with Distal Malignant Biliary Obstruction: An Underestimated Problem?","volume":"54","author":"Fugazza","year":"2022","journal-title":"Dig. Liver Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1055\/a-1324-7919","article-title":"Efficacy of Lumen-Apposing Metal Stents or Self-Expandable Metal Stents for Endoscopic Ultrasound-Guided Choledochoduodenostomy: A Systematic Review and Meta-Analysis","volume":"53","author":"Amato","year":"2021","journal-title":"Endoscopy"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1016\/j.gie.2013.11.021","article-title":"EUS-Guided Choledochoduodenostomy by Using a Biflanged Lumen-Apposing Metal Stent","volume":"79","author":"Itoi","year":"2014","journal-title":"Gastrointest. Endosc."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"588","DOI":"10.5946\/ce.2023.169","article-title":"Advances in Self-Expandable Metal Stents for Endoscopic Ultrasound-Guided Interventions","volume":"57","author":"Jang","year":"2024","journal-title":"Clin. Endosc."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1016\/j.gie.2024.05.024","article-title":"Indirect Comparison of Various Lumen-Apposing Metal Stents for EUS-Guided Biliary and Gallbladder Drainage: A Systematic Review and Meta-Analysis","volume":"100","author":"Singh","year":"2024","journal-title":"Gastrointest. Endosc."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1055\/a-1738-6780","article-title":"Therapeutic Endoscopic Ultrasound: European Society of Gastrointestinal Endoscopy (ESGE) Technical Review","volume":"54","author":"Bronswijk","year":"2022","journal-title":"Endoscopy"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"E1801","DOI":"10.1055\/a-1526-1208","article-title":"Common Bile Duct Size in Malignant Distal Obstruction and Lumen-Apposing Metal Stents: A Multicenter Prospective Study","volume":"9","author":"Anderloni","year":"2021","journal-title":"Endosc. Int. 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Hepatol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"E456","DOI":"10.1055\/a-2271-2145","article-title":"Outcomes Predictors in Endoscopic Ultrasound-Guided Choledochoduodenostomy with Lumen-Apposing Metal Stent: Systematic Review and Meta-Analysis","volume":"12","author":"Fugazza","year":"2024","journal-title":"Endosc. Int. 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Endosc."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.1016\/j.gie.2017.08.017","article-title":"Long-Term Outcomes of EUS-Guided Choledochoduodenostomy Using a Lumen-Apposing Metal Stent for Malignant Distal Biliary Obstruction: A Prospective Multicenter Study","volume":"87","author":"Tsuchiya","year":"2018","journal-title":"Gastrointest. Endosc."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.gie.2018.08.047","article-title":"Single-Stage EUS-Guided Choledochoduodenostomy Using a Lumen-Apposing Metal Stent for Malignant Distal Biliary Obstruction","volume":"89","author":"Anderloni","year":"2019","journal-title":"Gastrointest. Endosc."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"E1633","DOI":"10.1055\/a-1236-3217","article-title":"Safety and Outcomes of Endoscopic Ultrasound-Guided Drainage for Malignant Biliary Obstruction Using Cautery-Enabled Lumen-Apposing Metal Stent","volume":"8","author":"Chin","year":"2020","journal-title":"Endosc. Int. Open"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"6754","DOI":"10.1007\/s00464-020-08179-y","article-title":"Lumen Apposing Metal Stents versus Tubular Self-Expandable Metal Stents for Endoscopic Ultrasound-Guided Choledochoduodenostomy in Malignant Biliary Obstruction","volume":"35","author":"Fanjul","year":"2021","journal-title":"Surg. Endosc."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"4553","DOI":"10.1007\/s00464-021-08808-0","article-title":"EUS-Guided Biliary Drainage with LAMS for Distal Malignant Biliary Obstruction When ERCP Fails: Single-Center Retrospective Study and Maldeployment Management","volume":"36","author":"Amata","year":"2022","journal-title":"Surg. Endosc."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"3321","DOI":"10.1007\/s10620-019-05688-2","article-title":"EUS-Guided Choledochoduodenostomy for Distal Malignant Biliary Obstruction Using Electrocautery-Enhanced Lumen-Apposing Metal Stents: First US, Multicenter Experience","volume":"64","author":"Shah","year":"2019","journal-title":"Dig. Dis. Sci."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1016\/j.gie.2021.12.032","article-title":"EUS-Guided Choledochoduodenostomy for Malignant Distal Biliary Obstruction after Failed ERCP: A Retrospective Nationwide Analysis","volume":"95","author":"Fugazza","year":"2022","journal-title":"Gastrointest. Endosc."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"5002","DOI":"10.1007\/s00464-016-4845-6","article-title":"EUS-Guided Choledochoduodenostomy for Malignant Distal Biliary Obstruction Using a Lumen-Apposing Fully Covered Metal Stent after Failed ERCP","volume":"30","author":"Kunda","year":"2016","journal-title":"Surg. Endosc."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1016\/j.gie.2021.09.040","article-title":"EUS-Guided Choledochoduodenostomy with Electrocautery-Enhanced Lumen-Apposing Metal Stents in Patients with Malignant Distal Biliary Obstruction: Multicenter Collaboration from the United Kingdom and Ireland","volume":"95","author":"On","year":"2022","journal-title":"Gastrointest. Endosc."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1055\/a-2134-3537","article-title":"Endoscopic Ultrasound-Guided Choledochoduodenostomy Using Single-Step Lumen-Apposing Metal Stents for Primary Drainage of Malignant Distal Biliary Obstruction (SCORPION-p): A Prospective Pilot Study","volume":"56","author":"Fritzsche","year":"2024","journal-title":"Endoscopy"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1016\/j.gie.2024.10.012","article-title":"Optimizing EUS-Guided Choledochoduodenostomy with Lumen-Apposing Metal Stents for Primary Drainage of Malignant Distal Biliary Obstruction (SCORPION-IIp): A Prospective Pilot Study","volume":"101","author":"Fritzsche","year":"2025","journal-title":"Gastrointest. Endosc."},{"key":"ref_32","first-page":"e64","article-title":"Antegrade Transpapillary Biliary Stent Placement via Endosonography-Guided Choledochoduodenostomy for Treatment of Recurrent Cholangitis","volume":"34","author":"Voermans","year":"2022","journal-title":"Dig. Endosc."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"4873","DOI":"10.1007\/s00464-021-08435-9","article-title":"Is a Coaxial Plastic Stent within a Lumen-Apposing Metal Stent Useful for the Management of Distal Malignant Biliary Obstruction?","volume":"35","author":"Loras","year":"2021","journal-title":"Surg. Endosc."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Sumalla-Garcia, A., Aparicio-Tormo, J.R., Pedraza-Sanz, R., Sanchiz-Soler, V., Higuera, C.D.-L., Andujar, X., Vazquez-Sequeiros, E., Puigcerver-Mas, M., Martinez-Moreno, B., and Barbera, T. (2025). Lumen-Apposing Stents with or without Pigtail in Endosonography-Guided Biliary Drainage for Malignant Distal Biliary Obstruction. Clin. Gastroenterol. Hepatol.","DOI":"10.1016\/j.cgh.2025.05.025"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1076","DOI":"10.1055\/s-2003-44596","article-title":"Hepaticogastrostomy by Echo-Endoscopy as a Palliative Treatment in a Patient with Metastatic Biliary Obstruction","volume":"35","author":"Giovannini","year":"2003","journal-title":"Endoscopy"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Mazza, S., Masciangelo, G., Mauro, A., Scalvini, D., Torello Viera, F., Bardone, M., Veronese, L., Rovedatti, L., Agazzi, S., and Strada, E. (2024). Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction: A Comprehensive Review on Technical Tips and Clinical Outcomes. Diagnostics, 14.","DOI":"10.3390\/diagnostics14232644"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Matsubara, S., Nakagawa, K., Suda, K., Otsuka, T., Oka, M., and Nagoshi, S. (2022). Practical Tips for Safe and Successful Endoscopic Ultrasound-Guided Hepaticogastrostomy: A State-of-the-Art Technical Review. J. Clin. Med., 11.","DOI":"10.3390\/jcm11061591"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1016\/j.gie.2024.09.014","article-title":"Feasibility and Safety of EUS-Guided Biliary Drainage in Inexperienced Centers: A Multicenter Study in Southwest Japan","volume":"101","author":"Koga","year":"2025","journal-title":"Gastrointest. Endosc."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1097\/eus.0000000000000055","article-title":"Efficacy and Safety of EUS-Guided Hepatogastrostomy: A Systematic Review and Meta-Analysis","volume":"13","author":"Moond","year":"2024","journal-title":"Endosc. Ultrasound"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Alsakarneh, S., Madi, M.Y., Dahiya, D.S., Jaber, F., Kilani, Y., Ahmed, M., Beran, A., Abdallah, M., Al Ta\u2019ani, O., and Mittal, A. (2024). Is Endoscopic Ultrasound-Guided Hepaticogastrostomy Safe and Effective after Failed Endoscopic Retrograde Cholangiopancreatography?-A Systematic Review and Meta-Analysis. J. Clin. Med., 13.","DOI":"10.3390\/jcm13133883"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Li, J., Tang, J., Liu, F., and Fang, J. (2022). Comparison of Choledochoduodenostomy and Hepaticogastrostomy for EUS-Guided Biliary Drainage: A Meta-Analysis. Front. Surg., 9.","DOI":"10.3389\/fsurg.2022.811005"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1044","DOI":"10.1002\/ueg2.12552","article-title":"Long-Term Outcomes of Endoscopic Ultrasound-Guided Hepaticogastrostomy in Patients with Malignant Biliary Obstruction","volume":"12","author":"Hedjoudje","year":"2024","journal-title":"United Eur. Gastroenterol. J."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1007\/s10620-015-3933-0","article-title":"Endoscopic Ultrasound-Guided Biliary Drainage: A Systematic Review and Meta-Analysis","volume":"61","author":"Khan","year":"2016","journal-title":"Dig. Dis. Sci."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1055\/a-2282-3350","article-title":"Efficacy and Safety of Endoscopic Ultrasound-Guided Hepaticogastrostomy: A Meta-Regression Analysis","volume":"56","author":"Binda","year":"2024","journal-title":"Endoscopy"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1177\/1756283X16671671","article-title":"Optimal Biliary Access Point and Learning Curve for Endoscopic Ultrasound-Guided Hepaticogastrostomy with Transmural Stenting","volume":"10","author":"Oh","year":"2017","journal-title":"Therap. Adv. Gastroenterol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"110","DOI":"10.4103\/eus.eus_68_19","article-title":"Risk Factors for Adverse Events Associated with Bile Leak during EUS-Guided Hepaticogastrostomy","volume":"9","author":"Yamamoto","year":"2020","journal-title":"Endosc. Ultrasound"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1016\/j.gie.2020.03.3856","article-title":"Long-Term Outcomes of a Long, Partially Covered Metal Stent for EUS-Guided Hepaticogastrostomy in Patients with Malignant Biliary Obstruction (with Video)","volume":"92","author":"Nakai","year":"2020","journal-title":"Gastrointest. Endosc."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Facciorusso, A., Mangiavillano, B., Paduano, D., Binda, C., Crin\u00f2, S.F., Gkolfakis, P., Ramai, D., Fugazza, A., Tarantino, I., and Lisotti, A. (2022). Methods for Drainage of Distal Malignant Biliary Obstruction after ERCP Failure: A Systematic Review and Network Meta-Analysis. Cancers, 14.","DOI":"10.3390\/cancers14133291"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"e274","DOI":"10.1002\/deo2.274","article-title":"Endoscopic Ultrasound-Guided Hepaticogastrostomy versus Choledochoduodenostomy for Malignant Biliary Obstruction: A Meta-Analysis","volume":"4","author":"Yamazaki","year":"2023","journal-title":"DEN Open"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"e70037","DOI":"10.1002\/jgh3.70037","article-title":"Efficacy and Safety of Endoscopic Ultrasonography (EUS) Hepaticogastrostomy (HGS) versus Choledochoduodenostomy (CDS) in ERCP-Failed Malignant Biliary Obstruction: A Systematic Review and META-Analysis","volume":"8","author":"Rizqiansyah","year":"2024","journal-title":"JGH Open"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1177\/2050640618808147","article-title":"Outcomes of Endoscopic Ultrasound-Guided Biliary Drainage: A Systematic Review and Meta-Analysis","volume":"7","author":"Hedjoudje","year":"2019","journal-title":"United Eur. Gastroenterol. J."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1097\/SLE.0000000000000992","article-title":"Choledochoduodenostomy Versus Hepaticogastrostomy in Endoscopic Ultrasound-Guided Drainage for Malignant Biliary Obstruction: A Meta-Analysis and Systematic Review","volume":"32","author":"Mao","year":"2021","journal-title":"Surg. Laparosc. Endosc. Percutaneous Techniques"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"354","DOI":"10.4253\/wjge.v11.i5.354","article-title":"Comprehensive Review on EUS-Guided Biliary Drainage","volume":"11","author":"Salerno","year":"2019","journal-title":"World J. Gastrointest. Endosc."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1055\/a-2515-1712","article-title":"Randomized Comparison of Precut Papillotomy versus an Endoscopic Ultrasound-Guided Rendezvous Procedure for Difficult Biliary Access in Malignant Distal Biliary Obstruction","volume":"57","author":"Dhir","year":"2025","journal-title":"Endoscopy"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1111\/den.14393","article-title":"Current Status of Endoscopic Ultrasound-Guided Antegrade Intervention for Biliary Diseases in Patients with Surgically Altered Anatomy","volume":"35","author":"Iwashita","year":"2023","journal-title":"Dig. Endosc."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1002\/jhbp.823","article-title":"Endoscopic Ultrasound Guided-Antegrade Biliary Stenting vs Percutaneous Transhepatic Biliary Stenting for Unresectable Distal Malignant Biliary Obstruction in Patients with Surgically Altered Anatomy","volume":"27","author":"Iwashita","year":"2020","journal-title":"J. Hepatobiliary Pancreat. Sci."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Canakis, A., Tugarinov, N., Deliwala, S., Twery, B., Miro-Gonzalez, \u00c1., Beran, A., Gorman, E.F., Hathorn, K., Gilman, A.J., and Chawla, S. (2025). Clinical Outcomes of EUS-Guided Gallbladder Drainage in Patients with Acute Cholecystitis with \u22651 Year of Follow-up: A Systematic Review and Meta-Analysis. Gastrointest. Endosc.","DOI":"10.1016\/j.gie.2025.07.025"},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Khoury, T., Farraj, M., Sbeit, W., Fusaroli, P., Barbara, G., Binda, C., Fabbri, C., Basheer, M., Leblanc, S., and Fumex, F. (2025). EUS-Guided Gallbladder Drainage of Inoperable Malignant Distal Biliary Obstruction by Lumen-Apposing Metal Stent: Systematic Review and Meta-Analysis. Cancers, 17.","DOI":"10.3390\/cancers17121983"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1097\/eus.0000000000000108","article-title":"EUS-Guided Gallbladder Drainage as a Rescue in Distal Malignant Biliary Obstruction: A Systematic Review with Meta-Analysis","volume":"14","author":"Rizzo","year":"2025","journal-title":"Endosc. Ultrasound"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"8","DOI":"10.4103\/EUS-D-21-00206","article-title":"Efficacy and Safety of EUS-Guided Gallbladder Drainage for Rescue Treatment of Malignant Biliary Obstruction: A Systematic Review and Meta-Analysis","volume":"12","author":"Kamal","year":"2022","journal-title":"Endosc. Ultrasound"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1097\/eus.0000000000000116","article-title":"Outcomes of a Multicenter Registry on EUS-Guided Gallbladder Drainage as a Rescue Technique for Malignant Distal Biliary Obstruction after Failed Endoscopic Retrograde Cholangiopancreatography","volume":"14","author":"Escuer","year":"2025","journal-title":"Endosc. Ultrasound"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1111\/den.14750","article-title":"Effectiveness of Endoscopic Ultrasound (EUS)-Guided Choledochoduodenostomy vs. EUS-Guided Gallbladder Drainage for Jaundice in Patients with Malignant Distal Biliary Obstruction after Failed Endoscopic Retrograde Cholangiopancreatography: Retrospective, Multicenter Study (GALLBLADEUS Study)","volume":"37","author":"Debourdeau","year":"2025","journal-title":"Dig. Endosc."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Mangiavillano, B., Ramai, D., Fugazza, A., Franchellucci, G., Spadaccini, M., Barbera, C., Arcidiacono, P.G., De Nucci, G., Mart\u00ednez-Moreno, B., and Di Mitri, R. (2025). Endoscopic Ultrasound-Guided Gallbladder versus Bile Duct Drainage for First-Line Therapy of Malignant Biliary Obstruction: International Multicenter Trial. Endoscopy.","DOI":"10.1055\/a-2650-5492"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1097\/00000658-199503000-00008","article-title":"Cystic Duct Patency in Malignant Obstructive Jaundice. An ERCP-Based Study Relevant to the Role of Laparoscopic Cholecystojejunostomy","volume":"221","author":"Tarnasky","year":"1995","journal-title":"Ann. Surg."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1055\/a-1299-1495","article-title":"Endoscopic Ultrasound-Guided Gallbladder Drainage: A Backdoor for Biliary Decompression?","volume":"53","author":"Rizzatti","year":"2021","journal-title":"Endoscopy"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"17562848241273085","DOI":"10.1177\/17562848241273085","article-title":"Hepaticogastrostomy versus Hepaticogastrostomy with Antegrade Stenting for Malignant Biliary Obstruction: A Systematic Review and Meta-Analysis","volume":"17","author":"Paraskevopoulos","year":"2024","journal-title":"Therap. Adv. Gastroenterol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.gie.2024.02.012","article-title":"EUS-Guided Hepaticogastrostomy versus EUS-Guided Hepaticogastrostomy with Antegrade Stent Placement in Patients with Unresectable Malignant Distal Biliary Obstruction: A Propensity Score-Matched Case-Control Study","volume":"100","author":"Ishiwatari","year":"2024","journal-title":"Gastrointest. Endosc."},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"ASGE Standards of Practice Committee, Pawa, S., Marya, N.B., Thiruvengadam, N.R., Ngamruengphong, S., Baron, T.H., Bun Teoh, A.Y., Bent, C.K., Abidi, W., and Alipour, O. (2024). American Society for Gastrointestinal Endoscopy Guideline on the Role of Therapeutic EUS in the Management of Biliary Tract Disorders: Summary and Recommendations. Gastrointest. Endosc., 100, 967\u2013979.","DOI":"10.1016\/j.gie.2024.03.027"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1055\/a-1717-1391","article-title":"Therapeutic Endoscopic Ultrasound: European Society of Gastrointestinal Endoscopy (ESGE) Guideline","volume":"54","author":"Bronswijk","year":"2022","journal-title":"Endoscopy"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1089\/lap.2021.0587","article-title":"Comparing Outcomes Following Endoscopic Ultrasound-Guided Biliary Drainage Versus Percutaneous Transhepatic Biliary Drainage for Malignant Biliary Obstruction: A Systematic Review and Meta-Analysis","volume":"32","author":"Wang","year":"2022","journal-title":"J. Laparoendosc. Adv. Surg. Tech. A"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1097\/SLE.0000000000001192","article-title":"Endoscopic Ultrasound-Guided Versus Percutaneous Transhepatic Biliary Drainage After Failed ERCP: A Systematic Review and Meta-Analysis","volume":"33","author":"Giri","year":"2023","journal-title":"Surg. Laparosc. Endosc. Percutan Tech."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1053\/j.gastro.2023.07.024","article-title":"Endoscopic Ultrasound-Guided Biliary Drainage of First Intent With a Lumen-Apposing Metal Stent vs Endoscopic Retrograde Cholangiopancreatography in Malignant Distal Biliary Obstruction: A Multicenter Randomized Controlled Study (ELEMENT Trial)","volume":"165","author":"Chen","year":"2023","journal-title":"Gastroenterology"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1053\/j.gastro.2023.04.016","article-title":"EUS-Guided Choledocho-Duodenostomy Using Lumen Apposing Stent Versus ERCP With Covered Metallic Stents in Patients With Unresectable Malignant Distal Biliary Obstruction: A Multicenter Randomized Controlled Trial (DRA-MBO Trial)","volume":"165","author":"Teoh","year":"2023","journal-title":"Gastroenterology"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/j.gie.2024.04.019","article-title":"EUS- versus ERCP-Guided Biliary Drainage for Malignant Biliary Obstruction: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","volume":"100","author":"Barbosa","year":"2024","journal-title":"Gastrointest. Endosc."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1055\/a-2543-5672","article-title":"Biliary Drainage Prior to Pancreatoduodenectomy with Endoscopic Ultrasound-Guided Choledochoduodenostomy versus Conventional ERCP: Propensity Score-Matched Study and Surgeon Survey","volume":"57","author":"Fritzsche","year":"2025","journal-title":"Endoscopy"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"5036","DOI":"10.1245\/s10434-023-13466-8","article-title":"Pancreatoduodenectomy Following Preoperative Biliary Drainage Using Endoscopic Ultrasound-Guided Choledochoduodenostomy Versus a Transpapillary Stent: A Multicenter Comparative Cohort Study of the ACHBT-FRENCH-SFED Intergroup","volume":"30","author":"Janet","year":"2023","journal-title":"Ann. Surg. Oncol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/j.hpb.2020.06.001","article-title":"Pancreaticoduodenectomy Following Endoscopic Ultrasound-Guided Choledochoduodenostomy with Electrocautery-Enhanced Lumen-Apposing Stents an ACHBT-SFED Study","volume":"23","author":"Gaujoux","year":"2021","journal-title":"HPB"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"604","DOI":"10.5946\/ce.2024.218","article-title":"Primary Endoscopic Ultrasound-Guided Hepaticogastrostomy for Biliary Drainage Prior to Pancreatoduodenectomy: A Retrospective Study in Japan","volume":"58","author":"Okuno","year":"2025","journal-title":"Clin. Endosc."},{"key":"ref_79","doi-asserted-by":"crossref","unstructured":"Dell\u2019Anna, G., Nunziata, R., Delogu, C., Porta, P., Grassini, M.V., Dhar, J., Bar\u00e0, R., Bencardino, S., Fanizza, J., and Mandarino, F.V. (2024). The Role of Therapeutic Endoscopic Ultrasound in Management of Malignant Double Obstruction (Biliary and Gastric Outlet): A Comprehensive Review with Clinical Scenarios. J. Clin. Med., 13.","DOI":"10.3390\/jcm13247731"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"e8","DOI":"10.1016\/S2468-1253(25)00136-0","article-title":"Endoscopic Ultrasonography-Guided Gastroenterostomy versus Uncovered Duodenal Metal Stenting for Unresectable Malignant Gastric Outlet Obstruction (DRA-GOO): A Multicentre Randomised Controlled Trial","volume":"10","author":"Teoh","year":"2025","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"e132","DOI":"10.1002\/deo2.132","article-title":"Combined Endoscopic mAnagement of BiliaRy and gastrIc OutLET Obstruction (CABRIOLET Study): A Multicenter Retrospective Analysis","volume":"3","author":"Vanella","year":"2022","journal-title":"DEN Open"},{"key":"ref_82","first-page":"156","article-title":"Comparison of the Clinical Impact of Endoscopic Ultrasound-Guided Choledochoduodenostomy and Hepaticogastrostomy for Bile Duct Obstruction with Duodenal Obstruction","volume":"48","author":"Ogura","year":"2016","journal-title":"Endoscopy"}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/17\/21\/3428\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T02:36:32Z","timestamp":1761705392000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/17\/21\/3428"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,25]]},"references-count":82,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["cancers17213428"],"URL":"https:\/\/doi.org\/10.3390\/cancers17213428","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,25]]}}}