Introduction

Surgical anastomosis using sutures and metal titanium staples between various parts of the gastrointestinal (GI) tract and biliary tract has been the standard method to restore continuity after resection or to bypass blockage in otherwise unresectable disease. The role of flexible endoscopy has been largely limited to restoring continuity within the GI tract. Methods to create a palliative endoscopic gastroenteric or bilioenteric anastomosis have been reported in animal studies and some clinical trials. These include use of a compression button, compression coil, magnets, and a dedicated lumen-apposing metal stent. The role of endoscopic ultrasonography (EUS) in guiding these minimally invasive treatments has gained importance. This article focuses on a review of experimental and clinical studies of the creation of EUS-guided anastomoses.