Endoscopic-ultrasound-guided biliary drainage with placement of electrocautery-enhanced lumen-apposing metal stent for palliation of malignant biliary obstruction:Updated meta-analysis  

作　　者：Zu-Xiang Peng Fang-Fang Chen Wen Tang Xu Zeng Hong-Juan Du Ru-Xian Pi Hong-Ming Liu Xiao-Xiao Lu 

机构地区：[1]Department of Hepatobiliary Surgery,Daping Hospital,Army Medical University,Chongqing 400042,China [2]Department of Oncology,Chongqing General Hospital,Chongqing University,Chongqing 401147,China [3]Department of Gastroenterology and Hepatobiliary Surgery,People’s Hospital of Fenggang County,Guizhou 564200,Guizhou Province,China [4]Hepatobiliary and Pancreatic Tumor Center,Chongqing University Cancer Hospital,Chongqing 400030,China

出　　处：《World Journal of Gastrointestinal Surgery》2024年第3期907-920,共14页世界胃肠外科杂志（英文版）（电子版）

基　　金：The authors have read the PRISMA 2009 Checklist,and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.

摘　　要：BACKGROUND Endoscopic ultrasound-guided biliary drainage using electrocautery-enhanced(ECE)delivery of lumen-apposing metal stent(LAMS)is gradually being re-cognized as a viable palliative technique for malignant biliary obstruction after endoscopic retrograde cholangiopancreatography(ERCP)failure.However,most of the studies that have assessed its efficacy and safety were small and hetero-geneous.Prior meta-analyses of six or fewer studies that were published 2 years ago were therefore underpowered to yield convincing evidence.AIM To update the efficacy and safety of ECE-LAMS for treatment of biliary ob-struction after ERCP failure.METHODS We searched PubMed,EMBASE,and Scopus databases from the inception of the ECE technique to May 13,2022.Primary outcome measure was pooled technical success rate,and secondary outcomes were pooled rates of clinical success,re-intervention,and adverse events.Meta-analysis was performed using a random-effects model following Freeman-Tukey double-arcsine transformation in R soft-ware(version 4.1.3).RESULTS Fourteen eligible studies involving 620 participants were ultimately included.The pooled rate of technical success was 96.7%,and clinical success was 91.0%.Adverse events were reported in 17.5%of patients.Overall reinter-vention rate was 7.3%.Subgroup analyses showed results were generally consistent.CONCLUSION ECE-LAMS has favorable success with acceptable adverse events in relieving biliary obstruction when ERCP is impossible.The consistency of results across most subgroups suggested that this is a generalizable approach.

关 键 词：Biliary obstruction Biliary drainage Electrocautery-enhanced lumen-apposing metal stents Endoscopic ultrasound Endoscopic retrograde cholangiopancreatography failure 

分 类 号：R735.8[医药卫生—肿瘤]