EUS-BDの適応と選択

Indications for EUS-BD and selection of a method

要旨

　超音波内視鏡下胆道ドレナージ（EUS-BD）は，内視鏡的経乳頭的胆道ドレナージ（EBD）が不適あるいは不成功に終わった症例に対する補完的手技として現在普及が進んでいるが，デバイスの開発や手技の確立によって，より簡便かつ安全に行えるようになってきていることから，EBDと同等の位置づけとして評価する報告も近年出てきている。EUS-BDの代表的な手技は，EUS-HGS，EUS-CDS，EUS-AGS，EUS-RVであるが，これらの手技の概要と使い分けについて，EUS-BDの適応とともに解説した。

　EUS-guided biliary drainage (EUS-BD) is currently becoming more widely used as a complementary technique for cases where endoscopic transpapillary biliary drainage (EBD) is unsuitable or unsuccessful. However, most recently, there have been some reports evaluating it as in a similar position to EBD, because the procedures are becoming easier and safer with the development of devices and the establishment of techniques. The representative techniques of EUS-BD include EUS-HGS, EUS-CDS, EUS-AGS, and EUS-RV. We introduce these procedures and describe how to use them appropriately, as well as the indications for EUS-BD.