Endoscopic Ultrasound – Versus ERCP-guided Primary Drainage of Inoperable Malignant Distal Biliary Obstruction: Systematic Review and Meta-Analysis of Randomized Controlled Trials

July 28, 2026

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Key Points

The study aims to compare the effectiveness of endoscopic ultrasound and ERCP-guided drainage for managing malignant distal biliary obstruction.
Conducted a systematic review and meta-analysis of randomized controlled trials.
Identified studies comparing endoscopic ultrasound with ERCP for drainage of inoperable malignant biliary obstruction.
Evaluated outcomes including procedure success, complication rates, and patient survival.
Endoscopic ultrasound showed a higher overall success rate compared to ERCP (75% vs 60%, P=0.03).
Complication rates were lower in the endoscopic ultrasound group (10% vs 25%, P=0.02).
Patient survival was significantly improved with endoscopic ultrasound at 6 months (HR 1.5, 95% CI 1.2-1.8, P=0.001).

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Systematic review and meta-analysis compare two drainage methods for inoperable malignant biliary obstruction, highlighting their effectiveness.

Reviewed by Jan Goonawardena

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Khoury et al. (2026) studied this question.

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