Impact of EUS-guided choledochoduodenostomy versus transpapillary endoscopic biliary drainage on the intra- and post-operative outcome of pancreatoduodenectomy: a multicenter propensity score matched study

Aims Endoscopic ultrasound-guided choledochoduodenostomy (EUS-CDS) with lumen-apposing metal stents (LAMS) may be used in patients with a distal malignant biliary obstruction in whom either conventional biliary drainage by endoscopic retrograde cholangiopancreatography (ERCP) failed or as primary drainage approach in research setting. [1] [2] Although EUS-CDS has shown promising results, experience with EUS-CDS prior to pancreatoduodenectomy (PD) is still limited. [2] [3] [4] [5] [6] Therefore, in daily clinical practice multidisciplinary teams are reluctant to opt for EUS-CDS in patients with potentially resectable tumors. Aim of this study was to assess the impact of EUS-CDS on the intra- and post-operative outcome of PD when compared with transpapillary drainage.