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Is Endoscopic Ultrasound-Guided Hepaticogastrostomy Safe and Effective after Failed Endoscopic Retrograde Cholangiopancreatography?-A Systematic Review and Meta-Analysis.
Alsakarneh, Saqr; Madi, Mahmoud Y; Dahiya, Dushyant Singh; Jaber, Fouad; Kilani, Yassine; Ahmed, Mohamed; Beran, Azizullah; Abdallah, Mohamed; Al Ta'ani, Omar; Mittal, Anika; Numan, Laith; Goyal, Hemant; Bilal, Mohammad; Kiwan, Wissam.
Afiliación
  • Alsakarneh S; Department of Internal Medicine, University of Missouri-Kansas City, Kansas City, MO 64108, USA.
  • Madi MY; Department of Gastroenterology and Hepatology, Saint Louis University, Saint Louis, MO 63103, USA.
  • Dahiya DS; Division of Gastroenterology, Hepatology & Motility, The University of Kansas School of Medicine, Kansas City, KS 66103, USA.
  • Jaber F; Department of Internal Medicine, University of Missouri-Kansas City, Kansas City, MO 64108, USA.
  • Kilani Y; Department of Internal Medicine, Weill Cornell University, New York, NY 10065, USA.
  • Ahmed M; Department of Gastroenterology and Hepatology, University of Missouri-Kansas City, Kansas City, MO 64108, USA.
  • Beran A; Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
  • Abdallah M; Department of Gastroenterology and Hepatology, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
  • Al Ta'ani O; Department of Internal Medicine, Allegheny General Hospital, Allegheny, PA 15212, USA.
  • Mittal A; Department of Internal Medicine, University of Missouri-Kansas City, Kansas City, MO 64108, USA.
  • Numan L; Department of Gastroenterology and Hepatology, Saint Louis University, Saint Louis, MO 63103, USA.
  • Goyal H; Division of Gastroenterology and Hepatology, Borland Groover, Jacksonville, FL 32207, USA.
  • Bilal M; Division of Gastroenterology and Hepatology, University of Minnesota, Minneapolis, MN 55455, USA.
  • Kiwan W; Department of Gastroenterology and Hepatology, Saint Louis University, Saint Louis, MO 63103, USA.
J Clin Med ; 13(13)2024 Jul 01.
Article en En | MEDLINE | ID: mdl-38999449
ABSTRACT
Background/

Objectives:

Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) has emerged as an alternative option for biliary drainage in cases of failed endoscopic retrograde cholangiopancreatography (ERCP). Limited data exist on the safety and efficacy of EUS-HGS. In this comprehensive meta-analysis, we aim to study the safety and efficacy of EUS-HGS in cases of failed conventional ERCP.

Methods:

Embase, PubMed, and Web of Science databases were searched to include all studies that evaluated the efficacy and safety of EUS-HGS. Using the random effect model, the pooled weight-adjusted event rate estimate for clinical outcomes in each group were calculated with 95% confidence intervals (CIs). The primary outcomes were technical and clinical success rates. Secondary outcomes included overall adverse events (AEs), rates of recurrent biliary obstruction (RBO), and rates or re-intervention.

Results:

Our analysis included 70 studies, with a total of 3527 patients. The pooled technical and clinical success rates for EUS-HGS were 98.1% ([95% CI, 97.5-98.7]; I2 = 40%) and 98.1% ([95% CI, 97.5-98.7]; I2 = 40%), respectively. The pooled incidence rate of AEs with EUS-HGS was 14.9% (95% CI, 12.7-17.1), with bile leakage being the most common (2.4% [95% CI, 1.7-3.2]). The pooled incidence of RBO was 15.8% [95% CI, 12.2-19.4], with a high success rate for re-intervention (97.5% [95% CI, 94.7-100]).

Conclusions:

Our analysis showed high technical and clinical success rates of EUS-HGS, making it a feasible and effective alternative to ERCP. The ongoing development of dedicated devices and techniques is expected to make EUS-HGS more accessible and safer for patients in need of biliary drainage.
Palabras clave

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Clin Med Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Suiza

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Clin Med Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Suiza