Journal
JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES
Volume 26, Issue 7, Pages 249-269Publisher
WILEY
DOI: 10.1002/jhbp.631
Keywords
Biliary stricture; Endoscopic ultrasonography; EUS-guided biliary drainage; Interventional EUS
Categories
Funding
- FUJIFILM Medical Co., Ltd Funding Source: Medline
- Piolax Medical Devices, Inc. Funding Source: Medline
- Boston Scientific Japan K.K. Funding Source: Medline
- Gadelius Medical K.K. Funding Source: Medline
- Century Medical, Inc. Funding Source: Medline
- Japan Biliary Association Funding Source: Medline
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Endoscopic ultrasound/ultrasonography-guided biliary drainage (EUS-BD) is a relatively new modality for biliary drainage after failed or difficult transpapillary biliary cannulation. Despite its clinical utility, EUS-BD can be complicated by severe adverse events such as bleeding, perforation, and peritonitis. The aim of this paper is to provide practice guidelines for safe performance of EUS-BD as well as safe introduction of the procedure to non-expert centers. The guidelines comprised patient-intervention-comparison-outcome-formatted clinical questions (CQs) and questions (Qs), which are background statements to facilitate understanding of the CQs. A literature search was performed using the PubMed and Cochrane Library databases. Statement, evidence level, and strength of recommendation were created according to the GRADE system. Four committees were organized: guideline creation, expert panelist, evaluation, and external evaluation committees. We developed 13 CQs (methods, device selection, supportive treatment, management of adverse events, education and ethics) and six Qs (definition, indication, outcomes and adverse events) with statements, evidence levels, and strengths of recommendation. The guidelines explain the technical aspects, management of adverse events, and ethics of EUS-BD and its introduction to non-expert institutions.
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