Krishnamoorthi R, Dasari CS, Chandrasekar VT, et al. - Via performing a systematic review and meta-analysis, researchers sought to evaluate the effectiveness and safety of EUS-guided choledochoduodenostomy (CDD) using LAMS in patients who fail conventional endoscopic retrograde cholangiopancreatography (ERCP) for biliary drainage. Searching multiple databases through May 2019 to identify studies on CDD using covered self-expanding metal stents, they included seven studies on CDD using LAMS (with 284 patients) in the meta-analysis. They observed pooled rates of technical and clinical success (per-protocol analysis) were 95.7% and 95.9%, respectively. Pooled rate of postprocedure adverse events was 5.2% (95% CI 2.6–7.9). Jaundice had the pooled recurrence rate of 8.7% (95% CI 4.5–12.8). Findings support that for biliary decompression in patients who failed ERCP, CDD using LAMS/electrocautery-enhanced delivery system (EC-LAMS) is an effective and safe technique for these patients.