May 2, 2019

Endoscopic ultrasound-guided vs endoscopic retrograde cholangiopancreatography biliary drainage for obstructed distal malignant biliary strictures: A systematic review and meta-analysis

World Journal of Gastrointestinal Endoscopy
Fernanda P LogiudiceEduardo Guimarães Hourneaux de Moura


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. To compare EUS guidance and ERCP in terms of their effectiveness and safety in palliative biliary drainage for MBO. 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. The database searches yielded 5920 records, from which we selected 3 RCTs involving a total of 2...Continue Reading

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Mentioned in this Paper

Primary Health Care
Meta Analysis (Statistical Procedure)
Clinical Trials, Randomized
Adverse Event
Controlled Clinical Trials, Randomized
Endoscopic Ultrasound

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