Objective  To compare efficacy and safety of hepaticogastrostomy (HGS) and antegrade technique (AG) in treatment of patients with malignant obstructive jaundice by endoscopic ultrasonography-guided biliary drainage (EUS-BD).

  Methods  Totally 15 patients with malignant obstructive jaundice by EUS-BD from October 2014 to December 2018 were divided into EUS-HGS group (n=11) and EUS-AG group (n=4). The efficacy and safety were compared between two groups.

  Results  The success rates of operation in EUS-HGS group and EUS-AG group were 100.0%, clinical success rates were 90.9% and 75.0%, and the incidence rates of adverse events were 27.3% and 25.0%, respectively. There were no significant difference between two groups (P>0.05). The level of total bilirubin decreased significantly on the first day after operation in both groups (P < 0.05), but there was no significant difference between the two groups (P>0.05). There were no significant differences in hospitalization time and survival time between the two groups (P>0.05).

  Conclusion  Both EUS-HGS and EUS-AG are safe and effective ways for biliary drainage. Compared with EUS-AG, EUS-HGS has higher clinical success rate and incidence of complication.