Percutaneous transhepatic cholangiography vs endoscopic ultrasound-guided biliary drainage:A systematic review  

作　　者：Zeinab Hassan Eyad Gadour 

机构地区：[1]Internal Medicine,Stockport Hospitals NHS Foundation Trust,Manchester SK27JE,United Kingdom [2]Department of Gastroenterology,University Hospitals of Morecambe Bay NHS Foundation Trust,Lancaster LA14RP,United Kingdom

出　　处：《World Journal of Gastroenterology》2022年第27期3514-3523,共10页世界胃肠病学杂志（英文版）

摘　　要：BACKGROUND Percutaneous transhepatic cholangiography is a diagnostic and therapeutic procedure that involves inserting a needle into the biliary tree,followed by the immediate insertion of a catheter.Endoscopic ultrasound-guided biliary drainage(EUS-BD)is a novel technique that allows BD by echoendoscopy and fluoroscopy using a stent from the biliary tree to the gastrointestinal tract.AIM To compare the technical aspects and outcomes of percutaneous transhepatic BD(PTBD)and EUS-BD.METHODS Different databases,including PubMed,Embase,clinicaltrials.gov,the Cochrane library,Scopus,and Google Scholar,were searched according to the guidelines for Preferred Reporting Items for Systematic reviews and Meta-Analyses to obtain studies comparing PTBD and EUS-BD.RESULTS Among the six studies that fulfilled the inclusion criteria,PTBD patients underwent significantly more reinterventions(4.9 vs 1.3),experienced more postprocedural pain(4.1 vs 1.9),and experienced more late adverse events(53.8%vs 6.6%)than EUS-BD patients.There was a significant reduction in the total bilirubin levels in both the groups(16.4-3.3μmol/L and 17.2-3.8μmol/L for EUSBD and PTBD,respectively;P=0.002)at the 7-d follow-up.There were no significant differences observed in the complication rates between PTBD and EUSBD(3.3 vs 3.8).PTBD was associated with a higher adverse event rate than EUSBD in all the procedures,including reinterventions(80.4%vs 15.7%,respectively)and a higher index procedure(39.2%vs 18.2%,respectively).CONCLUSION The findings of this systematic review revealed that EUS-BD is linked with a higher rate of effective BD and a more manageable procedure-related adverse event profile than PTBD.These findings highlight the evidence for successful EUS-BD implementation.

关 键 词：Percutaneous transhepatic cholangiography Endoscopic ultrasound Biliary drainage Obstructive cholangiopathy 

分 类 号：R657.4[医药卫生—外科学]