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Efficacy and safety of EUS-guided biliary drainage for benign biliary obstruction – A systematic review and meta-analysis
BACKGROUND AND OBJECTIVES: ERCP is the first line of treatment for benign and malignant biliary obstruction and EUS-guided biliary drainage (EUS-BD) is usually used for patients who have failed ERCP. Recently, several studies have evaluated the role of EUS-BD in the management of benign biliary obst...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10237615/ https://www.ncbi.nlm.nih.gov/pubmed/36751758 http://dx.doi.org/10.4103/EUS-D-22-00077 |
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author | Kamal, Faisal Khan, Muhammad Ali Lee-Smith, Wade Sharma, Sachit Acharya, Ashu Farooq, Umer Tarar, Zahid Ijaz Faggen, Alec E. Aziz, Muhammad Chandan, Saurabh Ahmed, Zohaib Kouanda, Abdul Dai, Sun-Chuan Munroe, Craig A. Adler, Douglas G. |
author_facet | Kamal, Faisal Khan, Muhammad Ali Lee-Smith, Wade Sharma, Sachit Acharya, Ashu Farooq, Umer Tarar, Zahid Ijaz Faggen, Alec E. Aziz, Muhammad Chandan, Saurabh Ahmed, Zohaib Kouanda, Abdul Dai, Sun-Chuan Munroe, Craig A. Adler, Douglas G. |
author_sort | Kamal, Faisal |
collection | PubMed |
description | BACKGROUND AND OBJECTIVES: ERCP is the first line of treatment for benign and malignant biliary obstruction and EUS-guided biliary drainage (EUS-BD) is usually used for patients who have failed ERCP. Recently, several studies have evaluated the role of EUS-BD in the management of benign biliary obstruction. This meta-analysis evaluates the efficacy and safety of EUS-BD in the management of benign biliary obstruction. METHODS: We reviewed several databases from inception to July 8, 2022, to identify studies evaluating the efficacy and safety of EUS-BD in the management of benign biliary obstruction. Our outcomes of interest were technical success, clinical success, and adverse events. Pooled rates with 95% confidence intervals (CIs) for all outcomes were calculated using a random effects model. Subgroup analyses were performed including patients with normal anatomy versus surgically altered anatomy (SAA). Heterogeneity was assessed by I(2) statistic. RESULTS: We included 14 studies with 329 patients. The pooled rate (95% CI) of technical success was 88% (83%, 92%). The pooled rate (95% CI) of technical success for patients with SAA and normal anatomy was 92% (85%, 96%) and 83% (75%, 89%), respectively. The pooled rates (95% CI) of clinical success and adverse events were 89% (83%, 93%) and 19% (13%, 26%), respectively. We found low heterogeneity in most of the analyses. CONCLUSIONS: EUS-BD is an effective and safe option in patients with benign biliary obstruction and should be considered after a failed attempt at ERCP or when ERCP is not technically possible. |
format | Online Article Text |
id | pubmed-10237615 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-102376152023-06-03 Efficacy and safety of EUS-guided biliary drainage for benign biliary obstruction – A systematic review and meta-analysis Kamal, Faisal Khan, Muhammad Ali Lee-Smith, Wade Sharma, Sachit Acharya, Ashu Farooq, Umer Tarar, Zahid Ijaz Faggen, Alec E. Aziz, Muhammad Chandan, Saurabh Ahmed, Zohaib Kouanda, Abdul Dai, Sun-Chuan Munroe, Craig A. Adler, Douglas G. Endosc Ultrasound Original Article BACKGROUND AND OBJECTIVES: ERCP is the first line of treatment for benign and malignant biliary obstruction and EUS-guided biliary drainage (EUS-BD) is usually used for patients who have failed ERCP. Recently, several studies have evaluated the role of EUS-BD in the management of benign biliary obstruction. This meta-analysis evaluates the efficacy and safety of EUS-BD in the management of benign biliary obstruction. METHODS: We reviewed several databases from inception to July 8, 2022, to identify studies evaluating the efficacy and safety of EUS-BD in the management of benign biliary obstruction. Our outcomes of interest were technical success, clinical success, and adverse events. Pooled rates with 95% confidence intervals (CIs) for all outcomes were calculated using a random effects model. Subgroup analyses were performed including patients with normal anatomy versus surgically altered anatomy (SAA). Heterogeneity was assessed by I(2) statistic. RESULTS: We included 14 studies with 329 patients. The pooled rate (95% CI) of technical success was 88% (83%, 92%). The pooled rate (95% CI) of technical success for patients with SAA and normal anatomy was 92% (85%, 96%) and 83% (75%, 89%), respectively. The pooled rates (95% CI) of clinical success and adverse events were 89% (83%, 93%) and 19% (13%, 26%), respectively. We found low heterogeneity in most of the analyses. CONCLUSIONS: EUS-BD is an effective and safe option in patients with benign biliary obstruction and should be considered after a failed attempt at ERCP or when ERCP is not technically possible. Wolters Kluwer - Medknow 2023-02-06 /pmc/articles/PMC10237615/ /pubmed/36751758 http://dx.doi.org/10.4103/EUS-D-22-00077 Text en Copyright: © 2023 SCHOLAR MEDIA PUBLISHING https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Kamal, Faisal Khan, Muhammad Ali Lee-Smith, Wade Sharma, Sachit Acharya, Ashu Farooq, Umer Tarar, Zahid Ijaz Faggen, Alec E. Aziz, Muhammad Chandan, Saurabh Ahmed, Zohaib Kouanda, Abdul Dai, Sun-Chuan Munroe, Craig A. Adler, Douglas G. Efficacy and safety of EUS-guided biliary drainage for benign biliary obstruction – A systematic review and meta-analysis |
title | Efficacy and safety of EUS-guided biliary drainage for benign biliary obstruction – A systematic review and meta-analysis |
title_full | Efficacy and safety of EUS-guided biliary drainage for benign biliary obstruction – A systematic review and meta-analysis |
title_fullStr | Efficacy and safety of EUS-guided biliary drainage for benign biliary obstruction – A systematic review and meta-analysis |
title_full_unstemmed | Efficacy and safety of EUS-guided biliary drainage for benign biliary obstruction – A systematic review and meta-analysis |
title_short | Efficacy and safety of EUS-guided biliary drainage for benign biliary obstruction – A systematic review and meta-analysis |
title_sort | efficacy and safety of eus-guided biliary drainage for benign biliary obstruction – a systematic review and meta-analysis |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10237615/ https://www.ncbi.nlm.nih.gov/pubmed/36751758 http://dx.doi.org/10.4103/EUS-D-22-00077 |
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