• Medicina · Feb 2022

    Informed Consent for Endoscopic Biliary Drainage: Time for a New Paradigm.

    • Marco Spadaccini, Cecilia Binda, Alessandro Fugazza, Alessandro Repici, Ilaria Tarantino, Carlo Fabbri, Luigi Cugia, Andrea Anderloni, and On Behalf Of The Interventional Endoscopy Amp Ultra Sound I-Eus Group.
    • Digestive Endoscopy Unit, Department of Gastroenterology, Humanitas Clinical and Research Center, IRCCS, 20089 Rozzano, Milan, Italy.
    • Medicina (Kaunas). 2022 Feb 22; 58 (3).

    AbstractEndoscopic retrograde cholangiopancreatography (ERCP) is considered as the first option in the management of malignant biliary obstruction. In case of ERCP failure, percutaneous transhepatic biliary drainage (PTBD) has been conventionally considered as the preferred rescue strategy. However, the use of endoscopic ultrasound (EUS) for biliary drainage (EUS-BD) has proved similarly high rates of technical success, when compared to PTBD. As a matter of fact, biliary drainage is maybe the most evident paradigm of the increasing interconnection between ERCP and EUS, and obtaining an adequate informed consent (IC) is an emerging issue. The aim of this commentary is to discuss the reciprocal roles of ERCP and EUS for malignant biliary obstruction, in order to provide a guide to help in developing an appropriate informed consent reflecting the new biliopancreatic paradigm.

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