Evidence map›Paper›PMID 41131378›Full record

ArticleSurgical endoscopy2026

Endoscopic ultrasound-guided biliary drainage is cost-effective for treatment of malignant distal biliary obstruction after failed ERCP.

Noppachai Siranart, Patavee Pajareya, Steven N Steinway

Erratum issuedAbstract readComparative Study
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors.

Noppachai SiranartDivision of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.
Patavee PajareyaFaculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, 10330, Thailand.
Steven N SteinwayDivision of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA. ssteinway@bwh.harvard.edu.ORCID 0000-0002-4645-293X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEndoscopic ultrasound (EUS)-guided biliary drainage is a promising alternative for malignant distal biliary obstruction (MDBO) after failed endoscopic retrograde cholangiopancreatography (ERCP). This study evaluates the cost-effectiveness of EUS-guided gallbladder drainage (EUS-GB) and EUS-guided choledochoduodenostomy (EUS-CBD) compared to percutaneous transhepatic biliary drainage (PTBD) in these patients.

methodsA decision analysis model compared costs and quality-adjusted life years (QALYs) over two years for patients with MDBO after failed ERCP, undergoing EUS-GB, EUS-CBD, or PTBD. Incremental cost-effectiveness ratios (ICERs) and net monetary benefits (NMBs) were calculated at a willingness-to-pay threshold of $100,000 per QALY. Probabilistic and deterministic sensitivity analyses were performed.

resultsBoth EUS-GB and EUS-CBD were more cost-effective than PTBD. PTBD cost $14,988, EUS-GB cost $14,520 (adding 0.38 QALYs and $37,768 incremental NMB), and EUS-CBD cost $17,694 (adding 0.55 QALYs and $52,171 incremental NMB). Although PTBD had the lowest cost, it was dominated due to fewer QALYs. Results were robust in sensitivity analyses.

conclusionEUS-GB and EUS-CBD are more cost-effective than PTBD for MDBO after failed ERCP. EUS-GB offers similar value to EUS-CBD, potentially with lower reintervention rates. Endoscopic management should be prioritized over PTBD for these patients.

Indexed as

Cholangiopancreatography, Endoscopic RetrogradeCholestasisDrainageEndosonographyUltrasonography, InterventionalCholedochostomyCost-Benefit AnalysisDecision Support TechniquesFemaleHumansMaleQuality-Adjusted Life YearsTreatment FailureCholedochoduodenostomyCost effectiveness analysisEndoscopic ultrasoundERCPGallbladder drainageMalignant distal biliary obstructionPercutaneous transhepatic biliary drainage

Identifiers

PMID41131378

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.