Post written by GIE Senior Associate Editor David L. Diehl, MD, MASGE, AGAF, from the Department of Gastroenterology and Hepatology, Geisinger Medical Center, Danville, Pennsylvania, USA.

I sat down to write an Endoscopedia post on my recently published article, “The best of EUS in 2025.” 

I got about 500 words in, then decided to scrap that approach.

Here is the “TL;DR” (too long; didn’t read) version:

• EUS-guided access to the common bile duct for either a rendezvous procedure or direct drainage continues to be of interest. Several authors argue that this should be done soon in cases of failed biliary access by ERCP.
• Endohepatology continues to grow. Studies in my article included:
  • A meta-analysis showing EUS-guided liver biopsy specimens are comparable to percutaneous.
  • Close agreement of EUS-guided portal pressure measurement to the transjugular route in a group of patients who had both measurements done. 
  • Continued refinement of EUS-guided shear wave elastography to estimate liver fibrosis.
  • Superiority of EUS-guided coil plus glue injection over endoscopic-only glue for gastric varices.
• Be on the lookout for a new double-balloon device to make EUS-guided gastrojejunal lumen-apposing metal stent placement easier and safer.
• EUS-guided lumen-apposing metal stents can be used for malignant intestinal obstruction by creating a colocolostomy or enterocolostomy. It can be useful in some cases of peritoneal carcinomatosis such as ovarian cancer with intestinal obstruction.
• EUS-guided biopsy is imperative in cases of focal autoimmune pancreatitis with “focal disease” to rule out a tumor. In patients where the entire pancreas is affected, biopsy may not strictly be needed.

If EUS is your jam, I encourage you to read the whole article!

Read the full article online.

The information presented in Endoscopedia reflects the opinions of the authors and does not represent the position of the American Society for Gastrointestinal Endoscopy (ASGE). ASGE expressly disclaims any warranties or guarantees, expressed or implied, and is not liable for damages of any kind in connection with the material, information, or procedures set forth.