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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 | Thalidomide in the management of multiple myeloma显示文摘 | Barlogie B Zangari M Spencer T | | 0，，： | 2 |
| 3 | Astrocytes and epilepsy 显示文摘 | De-Lanerolle N C Lee T S Spencer D D | 2010 | Neurotherapeutics2010，7，4： | 1 |
| 4 | Appling the TranstheoreticalModel to Exercise:A Systematic and Comprehensive Review of theLiterature显示文摘 | Spencer L Adams T B Malone S | 2006 | Health Promotion Practice2006，7，4： | 1 |
| 5 | Transformation of Maize Calls and Regeneration of Fertile Transgenic Plants显示文摘 | Gordon-Kamm W J Spencer T M Mangano M L | 1990 | The Plant Cell1990，2，7： | 1 |
| 6 | Thalidomide in the management of multiple myeloma 显示文摘 | BARLOGIC B ZANGARI M SPENCER T | 2001 | Semin Hematol2001，38，： | 1 |
| 7 | Endogenous betaretroviruses of sheep: teaching new lessons in retroviral interference and adaptation显示文摘 | PALMARINI M MURA M SPENCER T E | 2004 | J Gen Virol2004，85，1： | 1 |
| 8 | Dynamic formation of a self- formed membrane by nanofiltration of a high - forinca - weight dye显示文摘 | Xu X T Caddis J L Spencer H G | 2000 | Desalination2000，129，： | 1 |
| 9 | Ovary-independent estrogen receptor expression in neonatal porcine endometrium 显示文摘 | Tarleton B J Wiley A A Spencer T E | 1998 | Biology of Reproduction1998，58，： | 1 |
| 10 | Transformation of maize cells and regeneration of fertile transgenic plants显示文摘 | Gordon-Kamm W J Spencer T M Mangano M L | 1990 | The Plant Cell1990，2，7： | 1 |
| 11 | Pregnancy recognition and conceptus implantation in domestic ruminants: roles of progesterone, interferons and endogenous retroviruses显示文摘 | Spencer T E Johnson G A Bazer F W | 2007 | Reproduction Fertility and Development2007，19，： | 1 |
| 12 | Early pregnancy: Concepts, challenges, and potential solutions 显示文摘 | Spencer T E | 2013 | Anita Front2013，3，： | 1 |
| 13 | Supplemental energy dissipation: State-of-the-art and state-of-the practice显示文摘 | Soong T T Spencer B F | 2002 | Engineering Structures2002，24，3： | 1 |
| 14 | Fetal-maternal interactions during the establishment of pregnancy in ruminants显示文摘 | SPENCER T E JOHNSON G A BAZER F W | 2007 | Soc Reprod Fertil Suppl2007，64，： | 1 |
| 15 | Effects of active versus passive recovery in sprint cross-country skiing显示文摘 | Losnegard T Andersen M Spencer M | 2015 | Int J Sports Physiol Perform2015，55，2： | 1 |
| 16 | Transformation of maize cells and regeneration of fertile transgenic plants显示文摘 | Gordon-kamm W J Spencer T M Mangeno M L | 1990 | Plant Cell1990，2，： | 1 |
| 17 | Uterine receptivity to implantation of blastocysts in mammals 显示文摘 | Bazer F W Spencer T E Johnson G A | 2011 | Front Biosci( Sehol Ed)2011，3，： | 1 |
| 18 | Targeting HSP 90 induces apoptosis and inhibits critical survival and proliferation pathways in multiple myeloma 显示文摘 | Khong T Spencer A | 2011 | Mol Cancer Ther2011，10，10： | 1 |
| 19 | Attention-deficit/ hyperactivity disorder and comorbidity显示文摘 | SPENCER T BIEDERMAN J WILENS T | 1999 | Pediatr Clin North Am1999，46，： | 1 |
| 20 | Strengtheningviatheformationofstrain-inducedmartensiteinstainlesssteels显示文摘 | Spencer K EmburyJ D Conlon K T etal | 2004 | MaterialsScienceandEngineeringA2004，，： | 1 |
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