Post written by Yusuke Ishida, MD, PhD, and Takehiko Koga, MD, PhD, from the Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Fukuoka, Japan.

This study aimed to evaluate the feasibility and safety of EUS-guided biliary drainage (EUS-BD) in inexperienced centers. Although EUS-BD has shown high success rates in high-volume centers, its outcomes in newly adopting centers remain underexplored. To address this gap, a multicenter retrospective study was conducted in 22 inexperienced centers, analyzing procedural outcomes, risk factors, and adverse events (AEs). 

Prior research predominantly originated from high-volume centers, potentially introducing publication bias. This study fills the gap by analyzing initial outcomes in centers with limited experience, determining whether advancements in devices and techniques have contributed to improved feasibility and safety, even in inexperienced settings.

Results showed that among 255 cases, the technical success rate was 91.4%, and the AE rate was 10.2%, comparable with that of experienced centers. Multivariate analysis identified a puncture target diameter of <5 mm as a significant risk factor for technical failure, and moderate ascites was associated with higher AE rates.

Notably, the experience level of endoscopists was not a major determinant of success, suggesting that advances in equipment and procedural knowledge have mitigated prior learning curve concerns.

These findings suggest that EUS-BD can be safely and effectively introduced in new centers with appropriate training and support. This study contributes to the growing body of evidence supporting the broader adoption of EUS-BD.

Read the full article online.

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