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| 1 | Endoscopic ultrasound-guided vs endoscopic retrograde cholangiopancreatography biliary drainage for obstructed distal malignant biliary strictures: A systematic review and meta-analysis显示文摘BACKGROUND For palliation of malignant biliary obstruction(MBO), the gold-standard method of biliary drainage is endoscopic retrograde cholangiopancreatography(ERCP)with the placement of metallic stents. Endoscopic ultrasound(EUS)-guided drainage is an alternative that is typically reserved for cases of ERCP failure.Recently, however, there have been robust randomized clinical trials(RCTs)comparing EUS-guided drainage and ERCP as primary approaches to MBO.AIM To compare EUS guidance and ERCP in terms of their effectiveness and safety in palliative biliary drainage for MBO.METHODS This was a systematic review and meta-analysis, in which we searched the MEDLINE, Excerpta Medica, and Cochrane Central Register of Controlled Trials databases. Only RCTs comparing EUS and ERCP for primary drainage of MBO were eligible. All of the studies selected provided data regarding the rates of technical and clinical success, as well as the duration of the procedure, adverse events, and stent patency. We assessed the risk of biases using the Jadad score and the quality of evidence using the Grading of Recommendations Assessment,Development and Evaluation criteria.RESULTS The database searches yielded 5920 records, from which we selected 3 RCTs involving a total of 222 patients(112 submitted to EUS and 110 submitted to ERCP). In the EUS and ERCP groups, the rate of technical success was 91.96%n and 91.81%, respectively, with a risk difference(RD) of 0.00%(95%CI:-0.07, 0.07;P = 0.97; I^2 = 0%). The clinical success was 84.81% and 85.53% in the EUS and ERCP groups, respectively, with an RD of-0.01%(95%CI:-0.12, 0.10; P = 0.90; I^2 =0%). The mean difference(MD) for the duration of the procedure was-0.12%(95%CI:-8.20, 7.97; P = 0.98; I^2 = 84%). In the EUS and ERCP groups, there were14 and 25 adverse events, respectively, with an RD of-0.06%(95%CI:-0.23, 0.12; P= 0.54; I^2 = 77%). The MD for stent patency was 9.32%(95%CI:-4.53, 23.18; P =0.19; I^2 = 44%). The stent dysfunction rate was significantly lower in the EUS t group(MD =-0.22%; 95 CI:-0.35,-0.08; P = 0.001; I^2 = 0%).CONCLUSION EUS represents an interesting alternative to ERCP for MBO drainage,demonstrating lower stent dysfunction rates compared with ERCP. Technical and clinical success, duration, adverse events and patency rates were similar. | Fernanda P Logiudice Wanderlei M Bernardo Facundo Galetti Vitor M Sagae Carolina O Matsubayashi Antonio C Madruga Neto Vitor O Brunaldi Diogo T H de Moura Tomazo Franzini Spencer Cheng Sergio E Matuguma Eduardo G H de Moura | 2019 | World Journal of Gastrointestinal Endoscopy2019，11，4： | 6 |
| 2 | Two new lanostanoids from Ganoderma lucidum 显示文摘 | FUJITA A ARISAWA W SAGA M | 1986 | J Nat Prod1986，49，6： | 1 |
| 3 | A novel homozygous Ile535Asn mutation in the rod cGMP phosphodiesterase beta-subunit gene in two brothers of a Japanese family with autosomal recessive retinitis pigmentosa显示文摘 | Saga M Mashima Y Akeo K | 1998 | Curr Eye Res1998，17，3： | 1 |
| 4 | Three new lanostanoids from Ganoderma lucidum 显示文摘 | ARISAWA M FUJITA A SAGA M | 1986 | J Nat Prod1986，49，4： | 1 |
| 5 | Overexpression of PTEN increases sensitivity to SN-38,an active metabolite of the topoisomerase I inhibitor irinotecan,in ovarian cancer cells显示文摘 | Saga Y Mizukami H Suzuki M | | 0，，： | 1 |
| 6 | In vivo genotoxicity of nrthu-phenylphenol, biphenyl, and thiabendazolc detected in multiple mouse organs by the alkaline single cell gel electrophore- sis assay显示文摘 | SASAKI YF SAGA A AKASAKA M | 1997 | Murat Res1997，395，23： | 1 |
| 7 | Abnormal fragile histidine triad expression in advanced cervical cancer and evaluation of its utility as a prognostic factor显示文摘 | Machida S Ohwada M Saga Y | 2003 | Oncol2003，65，1： | 1 |
| 8 | Distinct roles of Wnt/β-catenin and Bmp signaling during early cardiogenesis 显示文摘 | KLAUS A SAGA Y TAKETO M M | 2007 | Proceedings of the National Academy of Sciences of the United States of America2007，104，18： | 1 |
| 9 | Two new lanostanoids from Ganoderma lucidum 显示文摘 | Fujita A Arisawa M Saga M | 1986 | J Nat Prod1986，49，6： | 1 |
| 10 | DNA replication error is frequent in ovarian granulose cell tumors 显示文摘 | Suzuki M Ohwada M Saga Y | 2000 | Cancer Genetics Cytogeneties2000，122，1： | 1 |
| 11 | Mechanisms of paelitaxel-induced apoptosis in an ovarian cancer cell line and its paelitaxel-resistant clone显示文摘 | Sugimura M Sagae S Ishioka S | 2004 | Ontology2004，66，1： | 1 |
| 12 | In vitro fertilization (IVF) and artificial insemination (AI) by cryopreserved spermatozoa in mouse 显示文摘 | Okuyama M Isogai S Saga M | 1990 | Fertil Implant1990，7，： | 1 |
| 13 | Establishment and characterization of a new cell line (SKS) from neuroendocrine small cell carcinoma of the uterine cervix and its chemosensitivity显示文摘 | Saga Y Suzuki M Tamura N | | 0，，04： | 1 |
| 14 | Mutation of K-RAS protooncogene and loss of heterozygosity on 6p27 in serous and mucinous ovarian carcinomas显示文摘 | Saito S Saga Y | 2000 | Cancer Genet Cytogenet2000，118，： | 1 |
| 15 | Mutation of the SRC gene in endometrial carcinoma显示文摘 | Sugimura M Kobayashi K Sagae S | 2000 | Jpn J Cancer Res2000，91，4： | 1 |
| 16 | Molecular imaging of cancer: evaluating characters of individual Cancer by PET/SPECT imaging 显示文摘 | SAGA T KOIZUMI M FURUKAWA T | 2009 | Cancer Sci2009，100，3： | 1 |
| 17 | Improved intratumoral penetration of radiolabeled streptavidin in intraperitoneal tumors pretargeted with biotinylated antibody显示文摘 | Zhang M Yao Z Saga T | 1998 | J Nucl Med1998，39，1： | 1 |
| 18 | Scrotum exfoliative dermatit is with ulcers associated with treatment of acute promyelocytic leukemia with all-trans-retinoic acid显示文摘 | Tajima K Sagae M Yahagi A | 1998 | R insho Ketsueki1998，39，1： | 1 |
| 19 | Detection of in vivo genotoxicity of haloalkanes and haloalkenes carcinogenic to rodents by the alkaline single cell gel electrophoresis (comet) assay in multiple mouse organs显示文摘 | SASAKI Y F SAGA A AKASAKA M | 1998 | Mutat Res1998，419，13： | 1 |
| 20 | Blood pressure variability and organ damage in a general population : results from the PAME - LA study( Pression iArteriose Monitorate E Loro Association) 显示文摘 | Saga R Corrao G Bombelli M | 2002 | Hy- pertension2002，39，22： | 1 |
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