內視鏡超音波導引之膽胰內視鏡治療是在內視鏡逆行性膽胰道攝影失敗時除經皮穿肝引 流及手術外一項有效且安全的替代方式。整體的技術及臨床成功率，在EUS-BD 有90% 成功 率，在EUS-PDD 則有70%。整體的併發症約為15%。大部分的併發症都很輕微，但嚴重的 併發症大多發生在胰管引流。和經皮穿肝引流相比，EUS- BD 有相似的引流效果，但相對有 較高的安全率及成功率。在EUS-BD 方面，根據解剖位置的不同及是否內視鏡可達乳突，而 有不同的選擇方式。在EUS-PDD 方面。相對trans-papillary/trans- anastomosis，以transluminal 方式置放的支架可能有較多的術後併發症。目前此項技術仍具有挑戰性，需同時具有ERCP 及EUS 經驗的醫師來執行，並建議有外科醫師來支援較佳。目前適應症及引流方式尚未標準 化，未來仍需更多的研究來改善流程及器械的使用。

EUS-guided cholangio-pancreatic intervention is safe, efficacious, and a viable alternative to PTC or surgery in failed ERCP. The overall technical and clinical success rates are around 90% for biliary tree and 70% for pancreatic duct drainage. The overall EUS-CP complication rate was around 15%. Most of the complications are minor. However, severe complications can be encountered during pancreatic drainage. EUS-BD and PTBD appear to provide comparable efficacy, but EUS-BD may offer more safety and successful rate. In EUS-BD, there are diffident methods and procedures according to surgically altered anatomy and endoscopically accessible ampulla. In EUSPDD, relative to trans-papillary or trans-anastomotic stents, trans- luminal stents are at a higher risk of stent migration and resultant leakage of pancreatic fluids. EUS-guided cholangio-pancreatic intervention is technical challenge and should be performed by an experienced endoscopist skilled in both EUS and ERCP. The indications and methods are not standard yet and need more pro-specific study to improve the methods/procedures and instruments. (J Intern Med Taiwan 2016; 27: 184-189)