Alvarez-Sánchez MV, et al. - A pilot study was designed to investigate the feasibility and safety of endoscopic ultrasound-guided biliary drainage (EUS-BD) for malignant biliary obstruction associated with ascites. Technically, EUS-BD was identified to be feasible in patients with ascites. Results hereby suggested that in patients with ascites, EUS-BD could be a clinically effective and safe alternative after failed ERCP.