Table 4.

Advantages and disadvantages of the different techniques

	Advantages	Disadvantages
ERCP	Widely available Relative low complication rate (compared to PTBD and EUS-BD)	Not feasible in case of inaccessible papilla
PTBD	Available rescue therapy for ERCP failure	High complication rate (bleeding-infection) External catheter Contraindicated if ascites
EUS	Different possible approaches (HGA, CDS, GBD, RV) Internal drainage Same session of failed ERCP Fewer re-interventions	Not widely available High endoscopic ERCP/EUS expertise required Not yet standardized algorithm

ERCP: Endoscopic retrograde cholangiopancreatography; PTBD: Percutaneous transhepatic biliary drainage; EUS: Endoscopic ultrasonography; EUS-BD: Endoscopic ultrasonography-guided biliary drainage; HGA: Hepatogastric anastomosis; CDS: Choledochoduodenostomy; RV: Rendezvous; GBD: Transgallbladder drainage.