Guo J.Giovannini M.Sahai A.V.Saftoiu A.Dietrich C.F.Santo E.Fusaroli P.Siddiqui A.A.Bhutani M.S.Teoh A.Y.B.Irisawa A.Arias B.L.A.Achanta C.R.Jenssen C.Seo D.-W.Adler D.G.Kalaitzakis E.Artifon E.Itokawa F.Poley J.W.Mishra G.Ho K.Y.HSIU-PO WANGOkasha H.H.Lachter J.Vila J.J.Iglesias-Garcia J.Yamao K.Yasuda K.Kubota K.Palazzo L.Sabbagh L.C.Sharma M.Kida M.El-Nady M.Nguyen N.Q.Vilmann P.Garg P.K.Rai P.Mukai S.Carrara S.Parupudi S.Sridhar S.Lakhtakia S.Rana S.S.Ogura T.Baron T.H.Dhir V.Sun S.2021-01-152021-01-1520182303-9027https://www.scopus.com/inward/record.uri?eid=2-s2.0-85058474020&doi=10.4103%2feus.eus_53_18&partnerID=40&md5=0d35c0ec9cf1c442acad687199eed57dhttps://scholars.lib.ntu.edu.tw/handle/123456789/540918Background and Objectives: EUS-guided biliary drainage (EUS-BD) was shown to be useful for malignant biliary obstruction (MBO). However, there is lack of consensus on how EUS-BD should be performed. Methods: This was a worldwide multi-institutional survey among members of the International Society of EUS conducted in February 2018. The survey consisted of 10 questions related to the practice of EUS-BD. Results: Forty-six endoscopists of them completed the survey. The majority of endoscopists felt that EUS-BD could replace percutaneous transhepatic biliary drainage after failure of ERCP. Among all EUS-BD methods, the rendezvous stenting technique should be the first choice. Self-expandable metal stents (SEMSs) were recommended by most endoscopists. For EUS-guided hepaticogastrostomy (HGS), superiority of partially-covered SEMS over fully-covered SEMS was not in agreement. 6-Fr cystotomes were recommended for fistula creation. During the HGS approach, longer SEMS (8 or 10 cm) was recommended. During the choledochoduodenostomy approach, 6-cm SEMS was recommended. During the intrahepatic (IH) approach, the IH segment 3 was recommended. Conclusion: This is the first worldwide survey on the practice of EUS-BD for MBO. There were wide variations in practice, and randomized studies are urgently needed to establish the best approach for the management of this condition. ? 2018 SPRING MEDIA PUBLISHING CO. LTDConsensus; EUS-guided biliary drainage; Questionnaire survey[SDGs]SDG3Article; bare metal stenting; biliary tract drainage; choledochoduodenostomy; cholestasis; consensus development; endoscopic ultrasonography; endoscopist; fistula; gastrostomy; health survey; hepaticogastrostomy; human; intrahepatic bile duct; malignant neoplasm; percutaneous transhepatic drainage; practice guideline; treatment failurejournal article10.4103/eus.eus_53_182-s2.0-85058474020