Combined ERCP and transhepatic endoscopic ultrasound-guided stent placement for biliary drainage in malignant hilar obstruction: not too good to be true.

: Referring to Kongkam P et al. p. 55-62 Complete drainage of complex MHBO improves patient outcomes; however, complete drainage in high-grade MHBO is not only difficult to achieve but also difficult to maintain, as clogging and ingrowth result in limited stent patency. For two decades now, EUS-guided biliary drainage (EUS-BD) has increasingly been performed in malignant biliary obstruction (MBO) following failed ERCP as an alternative to PTBD, the historical gold standard for difficult biliary drainage. [Extracted from the article]