Therapeutic endoscopic ultrasound: where are we and where do we go?

Since the last decade, there has been a revolution in techniques using endoscopic ultrasound (EUS). This technique provides definitive endoscopic therapy in a wide array of patients in which classic endoscopic interventions have failed or are likely to fail. More specifically in the context of biliary strictures, gastric and duodenal stenosis, as well as hepatobiliary diseases resistant to classic endoscopic therapies. Despite the significant clinical added value of EUS, it seems to struggle to find a clear role in current guidelines. Our aim is to compare therapeutic EUS to the established order, identify a more well-defined role for EUS and improve safety and efficacy by improving the technical approaches.