Similar Efficacies of Endoscopic Ultrasound–guided Transmural and Percutaneous Drainage for Malignant Distal Biliary Obstruction  Tae Hoon Lee, Jun-Ho Choi, Do Hyun Park, Tae Jun Song, Dong Uk Kim, Woo Hyun Paik, Young Hwangbo, Sang Soo Lee, Dong Wan Seo, Sung Koo Lee, Myung-Hwan Kim  Clinical Gastroenterology and Hepatology  Volume 14, Issue 7, Pages 1011-1019.e3 (July 2016) DOI: 10.1016/j.cgh.2015.12.032 Copyright © 2016 AGA Institute Terms and Conditions

Figure 1 The all-in-one device for EUS-guided transmural biliary drainage. A 3F to 4F tapered metal tip introducer with a 7F outer sheath and a preloaded partially covered metal stent. Clinical Gastroenterology and Hepatology 2016 14, 1011-1019.e3DOI: (10.1016/j.cgh.2015.12.032) Copyright © 2016 AGA Institute Terms and Conditions

Figure 2 Study flow chart showing the number of patients at each step. Clinical Gastroenterology and Hepatology 2016 14, 1011-1019.e3DOI: (10.1016/j.cgh.2015.12.032) Copyright © 2016 AGA Institute Terms and Conditions

Figure 3 (A) Kaplan–Meier analysis with the log-rank test for stent patency in the EUS-BDS and PTBD groups. The median cumulative stent patency with EUS-BDS was similar to that with PTBD (P = .848). (B) Kaplan–Meier analysis with the log-rank test for survival in the EUS-BDS and PTBD groups. Patient survival was equal between both groups (P = .828). Clinical Gastroenterology and Hepatology 2016 14, 1011-1019.e3DOI: (10.1016/j.cgh.2015.12.032) Copyright © 2016 AGA Institute Terms and Conditions

Supplementary Figure 1 Biliary access algorithm for unsuccessful standard retrograde biliary cannulation. Standard retrograde biliary cannulation was defined as wire-guided biliary cannulation by using a sphincterotome or cannula. *Refer to Figure 3. Clinical Gastroenterology and Hepatology 2016 14, 1011-1019.e3DOI: (10.1016/j.cgh.2015.12.032) Copyright © 2016 AGA Institute Terms and Conditions

Supplementary Figure 2 EUS-CD with an all-in-one device in a patient with periampullary and distal duodenal invasion (upper panels). One-step metal stent placement without additional fistula dilation was performed using the transcholedochal approach (lower panels). For the deployment of this all-in-one device into the bile duct, the axis of the stent tip introducer was maintained toward the hilar portion in EUS-CD (upper panels). Clinical Gastroenterology and Hepatology 2016 14, 1011-1019.e3DOI: (10.1016/j.cgh.2015.12.032) Copyright © 2016 AGA Institute Terms and Conditions