Effectiveness and safety of EUS-guided choledochoduodenostomy using lumen-apposing metal stents (LAMS): a systematic review and meta-analysis.

Surgical Endoscopy
Rajesh KrishnamoorthiShayan Irani

Abstract

Endoscopic ultrasound-guided choledochoduodenostomy (CDD) is emerging as an alternative technique for biliary drainage in patients who fail conventional endoscopic retrograde cholangiopancreatography (ERCP). The lumen-apposing metal stents (LAMS) are being increasingly used for CDD. We performed a systematic review and meta-analysis to evaluate the effectiveness and safety of CDD using LAMS. We performed a systematic search of multiple databases through May 2019 to identify studies on CDD using covered self-expanding metal stents. Pooled rates of technical success, clinical success, adverse events, and recurrent jaundice associated with CDD using LAMS were estimated. A subgroup analysis was performed based on use of LAMS with electrocautery-enhanced delivery system (EC-LAMS). Seven studies on CDD using LAMS (with 284 patients) were included in the meta-analysis. Pooled rates of technical and clinical success (per-protocol analysis) were 95.7% (95% CI 93.2-98.1) and 95.9% (95% CI 92.8-98.9), respectively. Pooled rate of post-procedure adverse events was 5.2% (95% CI 2.6-7.9). Pooled rate of recurrent jaundice was 8.7% (95% CI 4.5-12.8). On subgroup analysis of CDD using EC-LAMS (5 studies with 201 patients), the pooled rates of ...Continue Reading

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Citations

Jun 1, 2021·Surgical Oncology Clinics of North America·Nadia V GuardadoBenoit Blondeau
Jul 28, 2021·Gastrointestinal Endoscopy·UNKNOWN Prepared by: ASGE TECHNOLOGY COMMITTEEDavid R Lichtenstein
Jun 21, 2021·Gastrointestinal Endoscopy·Tiffany Y ChuaJenifer R Lightdale
Sep 4, 2021·ACG Case Reports Journal·Shivanand Bomman, Rajesh Krishnamoorthi
Apr 27, 2021·Clinical Endoscopy·Takeshi Ogura, Kazuhide Higuchi

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