Endoscopic Ultrasound-Guided Bile Duct Access and Drainage: Antegrade Approaches

  • Nan Ge
  • Siyu SunEmail author


EUS-AG stenting is a viable treatment option for patients with bile duct stones or obstruction in whom ERCP has failed, primarily as a consequence of surgically altered anatomy, duodenal obstruction, or inability to cannulate the papilla. According to the literature, both the technical and clinical successful rate of EUS-AG are high (technical success: 85.7–100%; clinical success rate: 81.6–100%) and severe complications have not been reported. At present, it shows some possible advantages over other approach routes like ERCP, PTBD, or EUS-HG, although further study with a larger cohort is still needed to evaluate its efficacy and safety.


Endoscopic ultrasound Biliary drainage Antegrade Bile duct stones Endoscopic retrograde cholangiopancreatography Hepaticogastrostomy Obstructive jaundice Surgically altered anatomy Self-expandable metal stent Fine needle aspiration 

Supplementary material

Video 2.1

EUS-AG for the malignant bile duct drainage (MP4 39234 kb)


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Endoscopy CenterShengjing Hospital of China Medical UniversityShenyangChina

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