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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 | 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 |
| 3 | Helper (CD4^+ )and Cytotoxic (CD8^+ ) T Cells Promote the Pathology of Dystrophin-Defieient Muscle显示文摘 | Spencer M J Montecino Rodriquez E Dorshkind K | 2001 | Clin Immunol2001，98，2： | 1 |
| 4 | 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 |
| 5 | Fluorescence spectroscopy opens new windows into dissolved organic matter dynamics in freshwater ecosystems: a review显示文摘 | Fellman J B Hood E Spencer R G M | 2010 | Limnology and Oceanography2010，55，6： | 1 |
| 6 | Nitrite-induced deamination and hypo- chlorite-induced oxidation of DNA in intact human respiratory tract epithelial ceils 显示文摘 | Jeremy P Spencer E Whtteman M | 2000 | J Free Radical Biology & Medicine2000，28，7： | 1 |
| 7 | Nitrite-induced deamination and hypochlorite-induced oxidation of DNA in intact human respiratory tract epithelial cells 显示文摘 | SPENCER J P E WHITEMAN M JENNER A | 2000 | Free Radical Biology and Medicine2000，28，7： | 1 |
| 8 | The mental prosthesis:Assessing the speed of a p300-based brain-computer interface显示文摘 | Donchin E Spencer K M Wijesinghe R | 2000 | IEEE Trans Rehab ENG2000，8，2： | 1 |
| 9 | Diet modifications to improve finishing pig growth performance and pork quality attributes during periods of heat stress 显示文摘 | J D Spencer A M Gaines E P Berg | 2008 | J Anim Sci2008，83，1： | 1 |
| 10 | Molecular markers associated with linolenic acid content in soybean显示文摘 | Spencer M M Landau-Ellis D Meyer E J | 2004 | Journal of the American Oil Chemists Society2004，8，： | 1 |
| 11 | 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 |
| 12 | Influence of patient characteristics and renal function on factor Ⅹa inhibition pharmacokinetics and pharmacodynamics after enoxaparin administration in non-ST-segment elevation acute coronary syndromes显示文摘 | Becker R C Spencer F A Gibson M Rush J E Sanderink G Murphy S A | 2002 | Am Heart J2002，143，： | 1 |
| 13 | Differential glucocorticoid effects on stress-induced gene expression in the paraventricular nucleus of the hypothalamus and ACTH secretion in the rat显示文摘 | Pace TW Gaylord RI Jarvis E Girotti M Spencer RL | 2009 | Stress2009，12，5： | 1 |
| 14 | Smart sens- ing technology opportunities and challenges显示文摘 | Spencer B F J Ruiz-Sandoval M E Kurata N | 2004 | Journal o{ Structural Control and Health Monitoring2004，11，4： | 1 |
| 15 | Potent immunosuppressive activities of cytomegalovirus-encoded interleukin-10显示文摘 | Spencer J V Lockridge K M Barry P A Lin G Tsang M Penfold M E Schall T J | 2002 | J Virol2002，76，3： | 1 |
| 16 | Discovery and characterization of endometrial epithelial messenger ribonucleic acids using the ovine uterine gland knockout model显示文摘 | Spencer T E Stagg A G Joyce M M | 1999 | Endocrinology1999，140，9： | 1 |
| 17 | In vivo actions of insulin-like growth factor-I on bone formation显示文摘 | Spencer E M E C C Si C C Liu | 1989 | Acta Endocrinnol1989，121，： | 1 |
| 18 | Receptor usage and fetal expression of ovine endogenous betaretroviruses:Implications for coevolution of endogenous and exogenous retrovirus显示文摘 | Spencer T E Mura M Gray C A | 2003 | J Virol2003，77，： | 1 |
| 19 | Smart sensing technology: opportunities and challenges 显示文摘 | Spencer B F Ruiz-Sandoval M E Kurata N | 2004 | Structural Control and Health Monitoring2004，11，34： | 1 |
| 20 | Friendly viruses: the special relationship between endogenous retroviruses and their host显示文摘 | VARELA M SPENCER T E PALMARINI M | 2009 | Ann N Y Acad Sci2009，1178，： | 1 |
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