EUS-BD offers reduced pancreatitis risk compared to ERCP

A systematic review and meta-analysis revealed that endoscopic ultrasound-guided biliary drainage (EUS-BD) is a safe alternative to ERCP transpapillary drainage (ERCP-TPD) for primary biliary drainage in patients with distal malignant biliary obstruction (DMBO). Among 815 patients analyzed, clinical and technical success rates were similar for both techniques. However, EUS-BD showed a significant reduction in post-procedure pancreatitis risk, with a lower occurrence of adverse events compared to ERCP-TPD, along with shorter procedural times.