EUS-guided gallbladder drainage (EUS-GBD) as second option after failed ERCP for malignant distal biliary obstruction (MDBO)

Abstract Text A 64-year-old male was admitted for jaundice. He refused blood transfusions if necessary. CT scan showed pancreatic tumor with dilation of the biliary tree and liver metastasis. Two ERCP attempts failed. Precut biliary cannulation technique, and EUS-guided biliary drainage as hepaticogastrostomy or choledochoduodenostomy were avoided because of increased risk of bleeding. So, we performed a cholecystogastrostomy with a 15x10 lumen-apposing metal stent with an optimal clinical result. EUS-GBD was safe and effective as a second option of biliary drainage after failed ERCP for MDBO.