Ultrasound-guided Percutaneous Biliary Drainage Versus Endoscopic Ultrasound-guided Biliary Drainage

Inclusion Criteria: * Inoperable, malignant disease with extrahepatic bile duct obstruction (infra- hilar) * ERCP was not successful or wasn´t possible due to anatomical reasons (for example status post-gastrectomy) * At least twofold elevated bilirubin level (\> 2mg/dl) * Histologically verified malignant disease * Abdominal ultrasound was performed * Computed tomography or magnetic resonance imaging of the abdomen was performed * A written consent was given Exclusion Criteria: * Relevant blood coagulation disorder (Quick \< 50%, Partial thromboplastin time \> 50 sec., thrombocytes \< 50/nl) * Extrahepatic cholangiocellular carcinoma (Klatskin tumor) Bismuth II-IV or intrahepatic cholangiocellular carcinoma * Operable, malignant disease or disease which can be cured by chemotherapy (for example aggressive Non Hodgkin-lymphoma) * Pregnancy or breastfeeding * Participation in another trial concerning PTBD or EUBD