Percutaneous transhepatic or endoscopic ultrasound-guided biliary drainage in malignant distal bile duct obstruction using a self-expanding metal stent: study protocol for a prospective european multicenter trial (puma trial)

HIGHLIGHTS

SUMMARY

A recently published meta-analysis on PTBD versus EUS-BD recommended EUS-BD as the preferred method when ERCP fails as EUS-BD showed a higher clinical success rate, less AEs, and a lower rate of re-interventions. Plastic stents were used in PTBD although only metal stents were inserted in EUS-BD in two studies, fluoroscopic guidance was only used for bile duct access in several studies, benign and malignant diseases were mixed and PTBD had many scheduled re-interventions. On the other side, only one of six studies compared all three relevant . . .

 



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