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Endoscopic ultrasound-guided biliary drainage versus percutaneous transhepatic biliary drainage after failed endoscopic retrograde cholangiopancreatography: a meta-analysis

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ABSTRACT

The failure rate of endoscopic retrograde cholangiopancreatography for biliary cannulation is approximately 6%–7% in cases of obstructive jaundice. Percutaneous transhepatic biliary drainage (PTBD) is the procedure of choice in such cases. Endoscopic ultrasound-guided biliary drainage (EGBD) is a novel technique that allows biliary drainage by echoendoscopy and fluoroscopy using a stent from the biliary tree to the gastrointestinal tract. Information in PubMed, Scopus, clinicaltrials.gov and Cochrane review were analyzed to obtain studies comparing EGBD and PTBD. Six studies fulfilled the inclusion criteria. Technical (odds ratio (OR): 0.34; confidence interval (CI) 0.10–1.14; p=0.05) and clinical (OR: 1.48; CI 0.46–4.79; p=0.51) success rates were not statistically significant between the EGBD and PTBD groups. Mild adverse events were nonsignificantly different (OR: 0.36; CI 0.10–1.24; p=0.11) but not the moderate-to-severe adverse events (OR: 0.16; CI 0.08–0.32; p≤0.00001) and total adverse events (OR: 0.34; CI 0.20–0.59; p≤0.0001). EGBD is equally effective but safer than PTBD.

No MeSH data available.


PRISMA statement of the study.Abbreviations: PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analysis; ERCP, endoscopic retrograde cholangiopancreatographic.
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f1-ceg-10-067: PRISMA statement of the study.Abbreviations: PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analysis; ERCP, endoscopic retrograde cholangiopancreatographic.

Mentions: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement for reporting meta- analysis and systematic reviews as recommended by the Cochrane Collaborative was used for this meta-analysis (Figure 1).17 A comprehensive electronic literature search was conducted for all the clinical trials on treatment of failed ERCP-guided biliary decompression between the years 2000 and 2016 on PubMed, Scopus, Cochrane library and clinicaltrials.gov using all field “failed ERCP,” all field “Percutaneous biliary drainage” and all field “EUS-guided biliary drainage”; all three search headings were connected with Boolean operator “AND.” Studies published in English comparing EGBD with PTBD in cases of failed ERCP were included. Two hundred and ninety-two articles were found in the database. We included randomized controlled trials (RCTs), retrospective comparative studies and published abstracts reporting at least some adverse events. We excluded prospective non-RCTs, case reports, letters and comments. Studies were also excluded if the sample size was <20. Only human studies were included. A total of six studies met the above-mentioned criteria.4,12–16 Two studies were excluded as they included primary EGBD cases where ERCP was not tried as the primary procedure.18,19 A third study was excluded as they did not include the adverse event profile.20


Endoscopic ultrasound-guided biliary drainage versus percutaneous transhepatic biliary drainage after failed endoscopic retrograde cholangiopancreatography: a meta-analysis
PRISMA statement of the study.Abbreviations: PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analysis; ERCP, endoscopic retrograde cholangiopancreatographic.
© Copyright Policy
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC5384693&req=5

f1-ceg-10-067: PRISMA statement of the study.Abbreviations: PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analysis; ERCP, endoscopic retrograde cholangiopancreatographic.
Mentions: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement for reporting meta- analysis and systematic reviews as recommended by the Cochrane Collaborative was used for this meta-analysis (Figure 1).17 A comprehensive electronic literature search was conducted for all the clinical trials on treatment of failed ERCP-guided biliary decompression between the years 2000 and 2016 on PubMed, Scopus, Cochrane library and clinicaltrials.gov using all field “failed ERCP,” all field “Percutaneous biliary drainage” and all field “EUS-guided biliary drainage”; all three search headings were connected with Boolean operator “AND.” Studies published in English comparing EGBD with PTBD in cases of failed ERCP were included. Two hundred and ninety-two articles were found in the database. We included randomized controlled trials (RCTs), retrospective comparative studies and published abstracts reporting at least some adverse events. We excluded prospective non-RCTs, case reports, letters and comments. Studies were also excluded if the sample size was <20. Only human studies were included. A total of six studies met the above-mentioned criteria.4,12–16 Two studies were excluded as they included primary EGBD cases where ERCP was not tried as the primary procedure.18,19 A third study was excluded as they did not include the adverse event profile.20

View Article: PubMed Central - PubMed

ABSTRACT

The failure rate of endoscopic retrograde cholangiopancreatography for biliary cannulation is approximately 6%&ndash;7% in cases of obstructive jaundice. Percutaneous transhepatic biliary drainage (PTBD) is the procedure of choice in such cases. Endoscopic ultrasound-guided biliary drainage (EGBD) is a novel technique that allows biliary drainage by echoendoscopy and fluoroscopy using a stent from the biliary tree to the gastrointestinal tract. Information in PubMed, Scopus, clinicaltrials.gov and Cochrane review were analyzed to obtain studies comparing EGBD and PTBD. Six studies fulfilled the inclusion criteria. Technical (odds ratio (OR): 0.34; confidence interval (CI) 0.10&ndash;1.14; p=0.05) and clinical (OR: 1.48; CI 0.46&ndash;4.79; p=0.51) success rates were not statistically significant between the EGBD and PTBD groups. Mild adverse events were nonsignificantly different (OR: 0.36; CI 0.10&ndash;1.24; p=0.11) but not the moderate-to-severe adverse events (OR: 0.16; CI 0.08&ndash;0.32; p&le;0.00001) and total adverse events (OR: 0.34; CI 0.20&ndash;0.59; p&le;0.0001). EGBD is equally effective but safer than PTBD.

No MeSH data available.