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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 | Hydrogen peroxide induces oxidative DNA damage in rat type2 pulmonary epithelial cells显示文摘 | Meehan W J Spencer J P E Rannels D E | 1999 | Environmental and Molecular Mutagenesis1999，33，1： | 2 |
| 3 | Clostridium difficile Enteritis after Colectomy显示文摘 | Causey M Wayne Spencer Michael P Steele Scott R | 2009 | The American Surgeon2009，，12： | 2 |
| 4 | Simulation of Packing Density and Liquid Flow in Fixed Beds 显示文摘 | Spedding P L Spencer R M | 1995 | Computers and Chemical Engineering1995，19，： | 1 |
| 5 | Compliant joint design principles for high compressive load situations 显示文摘 | Alexandre E G Spencer P M Lan-y L H | 2005 | Journal of Mechanical Design2005，127，4： | 1 |
| 6 | Transbronchial biopsies provide longitudinal evidence for epithelial chimerism in children following sex mismatched lung transplantation显示文摘 | SPENCER H RAMPLING D AURORA P | 2005 | Thorax2005，60，1： | 1 |
| 7 | Contrasting influences of glucuronidation and O-methylation of epicatechin on hydrogen peroxide-induced cell death in neurons and fibroblasts显示文摘 | SPENCER J P SCHROETER H CROSSTHWAITHE A J | 2001 | Free Radic Biol Med2001，31，9： | 1 |
| 8 | Hybridization efficiency of the adhesive/dentin interface with wet bonding显示文摘 | Wang Y Spencer P | 2003 | J Dent Res2003，82，： | 1 |
| 9 | Thermodynamic behavior of metal chlorides and sulfates under the conditions of incineration furnaces显示文摘 | Verhulst D Buekens A Spencer P J | 1995 | Environ Sci Technol1995，30，1： | 1 |
| 10 | Adhesive phase separation at the dentin interface under wet bonding conditions显示文摘 | Spencer P Wang Y | 2002 | J Bio- med Mater Res2002，62，3： | 1 |
| 11 | Photoactivity in bismuth germanium oxide 显示文摘 | Lenzo P V Spencer E G Ballman A A | 1967 | Physics Review Letters1967，19，11： | 1 |
| 12 | Lathyrus Sativus (Grass Pea) and Its Neurotoxin ODAP显示文摘 | Yah Z Y Spencer P S Li Z X | 2006 | Phytochemistry2006，，67： | 1 |
| 13 | Insights into the effects of hyperlipoproteinemia on cyclosporine a biodistribution and relationship to renal function显示文摘 | Aliabadi HM Spencer TJ Mahdipoor P | 2006 | AAPS J2006，8，4： | 1 |
| 14 | Implementation of an active mass driver using acceleration feedback control显示文摘 | Dyke S J Spencer B F Jr Quast P | 1996 | Microcomputers in Civil Engineering:Special Issue on Active and Hybrid Structural Control1996，11，： | 1 |
| 15 | Morphological instability in epitaxially strained dislocation-free solid films显示文摘 | Spencer B J Voorhees P W Davis S H | 1991 | Physical Review Letters1991，67，26： | 1 |
| 16 | Critical review of the current status of thickness measurements for ultrathin SiO2 on Si Part V: Results of a CCQM pilot study 显示文摘 | Seah M P Spencer S J Bensebaa F | 2004 | Surface and Interface Analysis2004，36，9： | 1 |
| 17 | Peripheral nerve abnormalities in aging rats显示文摘 | Grover-Johnson N Spencer P S | 1981 | J Neuropathol Exp Neurol1981，40，2： | 1 |
| 18 | Postmortem proteolysis is reduced in transgenic mice overexpressing calpastatin 显示文摘 | Kent M P Spencer M J Koohmaraie M | 2004 | Journal of Animal Science2004，82，3： | 1 |
| 19 | Secure and defensive high self-esteem 显示文摘 | JORDAN C H SPENCER S J ZANNA M P | 2003 | Journal of Personality andSocial Psychology2003，，5： | 1 |
| 20 | Supercritical carbon dioxide extraction of vanilla显示文摘 | Barton P Spencer J S | 1991 | Journal of Supercritical Fluids1991，4，： | 1 |
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