A meta-analysis of the effectiveness and safety of endoscopic ultrasound-guided choledochoduodenostomy employing electrocautery-enhanced lumen-apposing metal stents for biliary drainage after failed endoscopic retrograde cholangiopancreatography

IF 1.4 Q4 GASTROENTEROLOGY & HEPATOLOGY

DEN open Pub Date : 2025-04-23 DOI:10.1002/deo2.70105

Safiya Ibnawadh, Abdulrahman Alfadda, Abdulrahman Ibnawadh

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Abstract

Objectives

Endoscopic ultrasound-biliary drainage and choledochoduodenostomy (EUS-CDD) are increasingly being used as alternative procedures for biliary drainage in patients in whom endoscopic retrograde cholangiopancreatography fails. Novel electrocautery-enhanced lumen-apposing metal stents (EC-LAMS) are expected to be widely used for EUS-CDD. We performed a systematic review and meta-analysis to evaluate the technical and clinical success of EUS-CDD using EC-LAMS.

Methods

We performed a comprehensive search of several databases from inception to May 2022 to search for relevant studies on the effectiveness and safety of endoscopic ultrasound-guided biliary drainage using EC-LAMS. The pooled rates of technical success, clinical success, and early and late adverse events were calculated.

Results

Ten studies with a total of 481 patients were included in this analysis. The overall technical success rate was 94.3%, 95% confidence interval [CI] (91.5%–96.2%), The overall clinical success rate was 94.9%, 95% CI (92%–96.7%). The overall early adverse event rate was 5.1%, 95% CI (3.4%–7.8%), and the overall late adverse event rate was 10.8%, 95% CI (6.6%–17.2%).

Conclusion

In patients with biliary obstruction with failed endoscopic retrograde cholangiopancreatography, EUS-CDD using EC-LAMS is a good alternate management option with a high success rate and relatively low adverse events.

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内镜下逆行胆管造影术失败后，超声引导下采用电促腔旁置金属支架胆总管十二指肠吻合术的有效性和安全性的荟萃分析

目的：内镜下超声胆道引流和胆总管十二指肠吻合术（EUS-CDD）越来越多地被用于内镜下逆行胆管造影失败的患者的胆道引流。新型电烧灼增强腔位金属支架（ec - lam）有望广泛应用于EUS-CDD。我们进行了系统回顾和荟萃分析，以评估使用ec - lam的EUS-CDD的技术和临床成功。方法综合检索自成立至2022年5月的多个数据库，检索超声内镜引导下ec - lam胆道引流术的有效性和安全性的相关研究。计算技术成功率、临床成功率以及早期和晚期不良事件的汇总率。结果10项研究共纳入481例患者。总技术成功率为94.3%，95%可信区间[CI](91.5% ~ 96.2%)，总临床成功率为94.9%,95% CI（92% ~ 96.7%）。总体早期不良事件发生率为5.1%,95% CI(3.4% ~ 7.8%)，总体晚期不良事件发生率为10.8%,95% CI（6.6% ~ 17.2%）。结论对于内镜逆行胆管造影失败的胆道梗阻患者，EUS-CDD联合ec - lam是一种成功率高、不良事件相对较低的良好替代治疗选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

DEN open

CiteScore

1.30

自引率

0.00%

发文量