Endoscopic retrograde cholangiopancreatography (ERCP) versus Endoscopic ultrasound-guided biliary drainage (EUS-BD) for malignant distal bile duct obstruction (MDBO) caused by unresectable pancreato-biliary malignancies.

Abstract

Endoscopic retrograde cholangiopancreatography (ERCP) with self-expanding metal stent (SEMS) is currently the first-line procedure for malignant distal bile duct obstruction (MDBO) in palliative patients. Endoscopic ultrasound-guided biliary drainage (EUS-BD) is a good alternative with excellent stent patency rates. However, the existing evidence comparing the efficacy of primary EUS-BD with ERCP for MDBO is conflicting.

Herein, we summarize the @GIJournal Twitter® discussion held on June 4th, 2023, during which we discussed the article by Teoh et al. titled “EUS-Guided Choledocho-duodenostomy (ECDS) 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)”¹ published in Gastroenterology, April 2023.

The session was moderated by Dr. Nadeem Tehami (NT [@helpatologist]) and the key findings were critically reviewed by Dr. Muhammad K. Hasan (MH [@DrHasan_Orlando]) and Dr. Srisha Hebbar (SH [@Srisha_Hebbar]). Dr. Abdullah Abbasi (AA [@abdullahabbasi]) and Dr. Aimen Farooq (AF [@AimenKhanMD]) prepared the summary of the article and participated in the discussion as trainee moderators.