EUS-BD Outperform BEA-ERCP in Complex Biliary Obstruction

In a multicenter study, endoscopic ultrasound-guided biliary drainage (EUS-BD) demonstrated superior efficacy to balloon enteroscopy-assisted ERCP (BEA-ERCP) for patients with surgically altered anatomy and unresectable malignant biliary obstruction. EUS-BD achieved a significantly higher technical success rate and shorter procedure times, while maintaining similar clinical success and adverse event rates. BEA-ERCP was identified as an independent predictor of technical failure, particularly in patients with Roux-en-Y reconstruction.