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- W3022904037 abstract "Background Current evidence supporting the utility of endoscopic ultrasound-guided biliary drainage (EUS-BD) as a first-line treatment option for malignant biliary obstruction (MBO) is limited. We conducted a meta-analysis to compare the performance of EUS-BD and endoscopic retrograde cholangiopancreatography-guided biliary drainage (ERCP-BD) as primary palliation of MBO. Methods We searched several databases for comparative studies evaluating EUS-BD vs. ERCP-BD in primary drainage of MBO up to 30 November 2018. The primary outcome was treatment success. Secondary outcomes included adverse events, stent patency, stent dysfunction, reinterventions, procedure duration, and overall survival. Fixed- and random-effects models were used to calculate the pooled estimates. Results Seven studies involving 445 patients were qualified for the final analysis (IDDF2019-ABS-0023 Figure 1). There was no difference in technical success (risk ratio [RR] 0.99; 95% confidence interval [95% CI]: 0.86–1.13), clinical success (RR 1.02; 95% CI: 0.94–1.12) and total adverse events (RR 0.82; 95% CI: 0.49–1.37) between the 2 procedures (IDDF2019-ABS-0023 Figure 2, 3). EUS-BD was associated with lower rates of post-procedure pancreatitis (RR 0.17; 95% CI: 0.05–0.53), stent dysfunction (RR 0.62; 95% CI: 0.40–0.97), and tumor in/overgrowth (RR 0.21; 95% CI: 0.07–0.70), but higher rates of post-procedure bleeding (RR 8.82; 95% CI: 1.08–72.21) and bile peritonitis (RR 4.84; 95% CI: 1.06–22.07). No differences were noted in reinterventions (RR 0.53; 95% CI: 0.22–1.25), procedure duration (weighted mean difference -2.11; 95% CI: -9.51–5.29), stent patency (hazard ratio [HR] 0.71; 95% CI: 0.45–1.11), and overall survival (HR 1.12; 95% CI: 0.80–1.58) (IDDF2019-ABS-0023 Figure 4, 5). Conclusions EUS-BD showed similar efficacy, safety, stent patency, and overall survival when compared with ERCP-BD for primary palliation of MBO, whereas exhibiting several clinical advantages (lower risk of post-procedure pancreatitis, stent dysfunction, and tumor in/overgrowth) and disadvantages (higher risk of post-procedure bleeding and bile peritonitis). Large-scale, well-organized, head-to-head studies are warranted." @default.
- W3022904037 created "2020-05-13" @default.
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- W3022904037 date "2019-06-01" @default.
- W3022904037 modified "2023-09-23" @default.
- W3022904037 title "IDDF2019-ABS-0023 EUS-guided versus ERCP-guided biliary drainage for primary palliation of malignant biliary obstruction: a systematic review and meta-analysis" @default.
- W3022904037 doi "https://doi.org/10.1136/gutjnl-2019-iddfabstracts.243" @default.
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