Lorenzo Camellini, Paolo Cecinato, Ramona Zecchini, Romano Sassatelli
Interest in EUS-guided biliary drainage is increasing and this approach is candidate to establish as an effective alternative to percutaneous transhepatic cholangiography, when endoscopic access to the papilla is precluded because of duodenal stenosis, periampullary tumor invasion, or previous surgery; nevertheless this method is far from being standardized and many technical issues need to be clarified. [1-6] We present hereby three cases from our experience which we think they can exemplify some of the choices and difficulties, that could be faced by the operators novice in EUS-guided drainage.
Why do we need contrast agents in EUS? Although EUS has a very good accuracy for the study of inner organs compared to transabdominal ultrasound, it has certain limitations that would make tissue enhancement desirable.