Endoscopic ultrasound-guided biliary drainage versus percutaneous transhepatic biliary drainage after failed endoscopic retrograde cholangiopancreatography: a meta-analysis.
Endoscopic ultrasound-guided biliary drainage versus percutaneous transhepatic biliary drainage after failed endoscopic retrograde cholangiopancreatography: a meta-analysis.
复制标题
DOI：
10.2147/ceg.s132004
复制
发表时间：
2017
影响因子：
2.4
通讯作者：
Bachuwa G
中科院分区：
文献类型：
--
作者：
Baniya R;Upadhaya S;Madala S;Subedi SC;Shaik Mohammed T;Bachuwa G
胆道插管内窥镜逆行胰胆管造影术的失败率约为6%~7%。经皮肝穿胆管引流术(PTBD)是此类病例的首选方法。经内窥镜超声引导胆道引流(EGBD)是一种新的技术，可以通过内窥镜和透视使用支架从胆道树到胃肠道进行胆道引流。分析PubMed、Scope us、Clinicaltrials.gov和Cochrane Review中的信息，以获得比较EGBD和PTBD的研究。6项研究符合纳入标准。技术(优势比(OR)：0.34；可信区间(CI)0.10~1.14；p=0.05)和临床(OR：1.48；CI 0.46~4.79；p=0.51)成功率在EGBD组和PTBD组之间无统计学意义。轻度不良事件差异无统计学意义(OR：0.36；CI 0.10~1.24；p=0.11)，而中、重度不良事件(OR：0.16；CI 0.08~0.32；p≤0.00001)和总不良事件(OR：0.34；CI 0.20~0.59；p≤0.0001)差异无统计学意义。EGBD与PTBD同样有效，但更安全。
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.