ASGE Therapeutic EUS for Advanced Endosonographers (On-Demand) | September 2022-EUS Guided Biliary and Pancreatic Access

Video Transcription

Video Summary

In the video, Dr. Amy Tyberg discusses EUS-guided biliary and pancreatic access as a therapeutic option when conventional ERCP is unsuccessful. For biliary drainage, she explains that conventional ERCP is the gold standard, but 3-5% of cases cannot be managed this way. EUS-guided biliary drainage provides an alternative for these patients, with studies showing high technical and clinical success rates. There are different techniques for EUS-guided biliary drainage depending on whether an intrahepatic or extrahepatic approach is taken. Dr. Tyberg also discusses the different stent options available and factors to consider in selecting the appropriate stent. For pancreatic duct drainage, EUS-guided access is an option when conventional ERCP is not feasible. The procedure is technically complex and carries a higher risk of complications. Dr. Tyberg advises caution when performing this procedure and recommends it be done at expert tertiary care centers. The video concludes with a discussion on training and the importance of a multidisciplinary approach and proper equipment. Dr. Tyberg also answers questions from online participants regarding techniques and management of complications.

Asset Subtitle

Amy M. Tyberg, MD, FASGE

Keywords

video

Dr. Amy Tyberg

EUS-guided biliary and pancreatic access

therapeutic option

conventional ERCP

biliary drainage

pancreatic drainage

stent options