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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 | Clostridium difficile Enteritis after Colectomy显示文摘 | Causey M Wayne Spencer Michael P Steele Scott R | 2009 | The American Surgeon2009，，12： | 2 |
| 3 | Simulation of Packing Density and Liquid Flow in Fixed Beds 显示文摘 | Spedding P L Spencer R M | 1995 | Computers and Chemical Engineering1995，19，： | 1 |
| 4 | 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 |
| 5 | Critical review of the current status of thickness measurements for ultrathin SiO2 on Si Part V: Results of a CCQM pilot study 显示文摘 | Seah M P Spencer S J Bensebaa F | 2004 | Surface and Interface Analysis2004，36，9： | 1 |
| 6 | Postmortem proteolysis is reduced in transgenic mice overexpressing calpastatin 显示文摘 | Kent M P Spencer M J Koohmaraie M | 2004 | Journal of Animal Science2004，82，3： | 1 |
| 7 | Secure and defensive high self-esteem 显示文摘 | JORDAN C H SPENCER S J ZANNA M P | 2003 | Journal of Personality andSocial Psychology2003，，5： | 1 |
| 8 | 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 |
| 9 | The safety and efficacy of the artificial bowel sphincter for fecal incontinence:results from a multicenter conhort study 显示文摘 | WONG W D CONGLIOSI S M SPENCER M P | 2002 | Dis Colon Rectum2002，45，： | 1 |
| 10 | Rapid prototyping of metal parts by three-dimensional welding显示文摘 | Spencer J D Dickens P M Wykes C M | 1998 | Proceedings of the Institution of Mechanical Engineers Part B:Journal of Engineering Manufacture1998，212，3： | 1 |
| 11 | Educationa risk and resilience in African-American youth:Context,self,action,and outcomes in school显示文摘 | Connell J P Spencer M B Aber J L | 1994 | Child Development1994，，65： | 1 |
| 12 | 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 |
| 13 | Impact of preventing exacerbations on deterioration of health status in COPD 显示文摘 | Spencer S Calverley P M Burge P S | 2004 | Eur Respir J2004，23，5： | 1 |
| 14 | Controlled cord traction in management of the third stage of labour显示文摘 | Spencer P M | 1962 | Br Med J1962，，5294： | 1 |
| 15 | 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 |
| 16 | Rapid Prototyping of Metal Parts by Three-dimensional Welding显示文摘 | Spencer J D Dickens P M Wykes C M | 1998 | Proceedings of the Institution of Mechanical Engineers Part B: Journal of Engineering Manufacture1998，212，3： | 1 |
| 17 | The role of control-structure interaction in protective system design显示文摘 | Dyke S J Spencer Jr B F Quast P Sain M K | 1995 | Journal of Engineering Mechanics1995，121，2： | 1 |
| 18 | Integrating Eucalypt Forest Inventory and GIS in Western Australia 显示文摘 | Spencer RD Green M A Blggs P H | 1997 | Photogrammetric Engineering & Remote Sensing1997，63，12： | 1 |
| 19 | An Openhole Memory-log- ging System for High-angle Wells and Bad Hole Condi- tions显示文摘 | Elkinfton P A S Spencer M C | 2004 | SPE2004，2，： | 1 |
| 20 | 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 |
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