Role of EUS-guided biliary drainage in malignant distal biliary obstruction - an international survey
Thank you for agreeing to take this survey, which should take no longer than 5-7 minutes to complete.

We, Vincent Palmieri and Yen-I Chen, belong to a research group based out of the McGill University Health Centre that is in the midst of conducting a randomized controlled trial comparing EUS-guided biliary drainage versus ERCP in malignant biliary obstruction. The purpose of this survey study is to gain insight into current international practice patterns surrounding EUS-guided biliary drainage prior to the trial results.

We intend to publish the results of this survey. By voluntarily completing the survey, you imply your consent for the data to be used for this purpose. Participants’ identities will remain anonymous, and the data will be stored safely in an encrypted and password-protected manner such that access will be exclusively limited to the investigators: Vincent Palmieri, MSc (vincent.palmieri@mail.mcgill.ca) and Yen-I Chen, MD (yen-i.chen@mcgill.ca). The investigators have no funding to report for this survey study.
1. What is your age? *
2. What is your gender? *
3. Where do you practice? *
4. What is your specialty? *
5. How many years have you been in independent practice? *
6. Which of the following best describes your practice? *
7. Do you perform endoscopic retrograde cholangio-pancreatography (ERCP)? *
8. Do you have access to endoscopic ultrasound-guided biliary drainage (EUS-BD) services at your institution(s)? *
9. Do you perform EUS-BD for malignant biliary obstruction? *
10. Have you received formal training (as part of an advanced/therapeutic endoscopy training program) in EUS-BD? *
11. In patients with palliative/unresectable malignant distal biliary obstruction without concomitant gastric outlet obstruction, what is your next step for biliary drainage if ERCP fails? *
12. In patients with borderline resectable pancreatic cancer undergoing neoadjuvant chemotherapy with curative intent who present with distal biliary obstruction, what is your next step for biliary drainage if ERCP fails? *
13. What is/are your main concern(s) (if any) regarding EUS-BD in unresectable/palliative distal malignant biliary obstruction? Please select all that may apply. *
Required
14. What is/are your main concern(s) (if any) regarding EUS-BD via choledochoduodenostomy in borderline resectable disease? Please select all that may apply. *
Required
15. Would you ever consider EUS-BD as a first-line drainage approach in cases of malignant distal biliary obstruction (i.e. when ERCP has not been attempted)? *
16. What is/are your main concern(s) (if any) regarding EUS-BD as a first-line drainage approach in cases of malignant distal biliary obstruction (i.e. when ERCP has not been attempted)? Please select all that may apply. *
Required
17. What is your impression of the rates of technical and/or clinical success with EUS-BD, compared with ERCP, in the drainage of malignant biliary obstruction? *
18. What is your impression of the procedure time required with EUS-BD, compared with ERCP, in the drainage of malignant biliary obstruction? *
19. What is your impression of the risk of stent occlusion with EUS-BD, compared with ERCP, in the drainage of malignant biliary obstruction? *
20. What is your impression of the overall (early and late) adverse event profile of EUS-BD, compared with ERCP, in the drainage of malignant biliary obstruction? *
21. What is your impression of the rate of pancreatitis with EUS-BD, compared with ERCP, in the drainage of malignant biliary obstruction? *
22. For those who perform EUS-BD, what do you think are the major barriers in the dissemination of this technique in clinical practice? Please select all that may apply. *
Required
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