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April 10, 2026Digestive Endoscopy2 citations

Management of ERCP Failure in Malignant Biliary Obstruction: Comparative Effectiveness and Safety of EUS ‐Guided Gallbladder Drainage Versus Choledocoduodenostomy

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BMBenedetto MangiavillanoGFGianluca FranchellucciFAFrancesco Auriemma

Key Points

  • This research investigates the efficacy and safety of EUS-guided gallbladder drainage compared to choledocoduodenostomy in managing malignant biliary obstruction after failed ERCP.
  • Compared EUS-guided gallbladder drainage (EUS-GBD) and choledocoduodenostomy (EUS-CDS) outcomes in patients with malignant biliary obstruction (MDBO).
  • Assessed rates of efficacy and safety post-procedure.
  • Included patients without previous cholecystectomy and with clear cystic duct patency.
  • Both EUS-GBD and EUS-CDS showed comparable efficacy in MDBO management.
  • The safety profiles of EUS-GBD and EUS-CDS were similarly favorable.
  • EUS-GBD could be a simpler and safer alternative for suitable MDBO patients.

Abstract

In patients with MDBO after failed ERCP, EUS-GBD or EUS-CDS were comparable with similar rates of efficacy and safety. EUS-GBD could represent an easy and safe option in MDBO patients without previous cholecystectomy and with a clear patency of the cystic duct.

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Cite This Study

Mangiavillano et al. (2026) studied this question.

synapsesocial.com/papers/69d8962d6c1944d70ce076cbhttps://doi.org/10.1111/den.70145
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Multicenter Analysis of the Learning Curve for Endoscopic Ultrasound‐Guided Gallbladder Drainage: A Cumulative Sum Approach2026 · 3 citations
  2. 2Effectiveness 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)2024 · 38 citations
  3. 3EUS-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)2023 · 158 citations
  4. 4Learning curve for EUS-guided biliary drainage: What have we learned?2020 · 58 citations
  5. 5Papillary cannulation and sphincterotomy techniques at ERCP: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline2016 · 668 citations