Balloon Enteroscopy‐Assisted ERCP Versus Endoscopic Ultrasound‐Guided Biliary Drainage for Unresectable Malignant Biliary Obstruction in Patients With Surgically Altered Anatomy: A Multicenter Prospective Registration Study

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EUS-guided biliary drainage demonstrated a significantly higher technical success rate for patients with malignancies.
Procedure time was significantly shorter with EUS-guided biliary drainage compared to balloon enteroscopy assistance.
Technical failure rates were lower in EUS-guided drainage, especially in patients with Roux-en-Y reconstruction.
EUS-guided biliary drainage showed comparable adverse events and clinical success rates relative to balloon enteroscopy.

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Multicenter trial shows EUS-guided biliary drainage outperforms balloon enteroscopy in patients with altered anatomy.

Itonaga et al. (2025) studied this question.

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