Abstract
Alternative biliary decompression techniques include percutaneous transhepatic cholangiography (PTC) and drainage and surgical biliary bypass. EUS-guided biliary access and transgastric or transesophageal biliary decompression have been performed successfully for long-term palliation. These techniques are used when transduodenal biliary drainage is unsuccessful or inadequate. This video describes indications of the procedures, including a step-by-step demonstration of an actual procedure, and discusses potential adverse events (Fig. 1; Video, available online at www.giejournal.org).
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