EUS-guided biliary drainage with electrocautery-enhanced lumen-apposing metal stent placement should replace PTBD after ERCP failure in patients with distal tumoral biliary obstruction: a large real-life study

Ginestet, C; Sanglier, Florian; Hummel, Vincent; Rouchaud, Aymeric; Legros, Romain; Lepetit, Hugo; Dahan, Martin; Carrier, Paul; Loustaud‐Ratti, Véronique; Sautereau, Denis; Albouys, Jérémie; Jacques, Jérémie; Geyl, Sophie

doi:10.1007/s00464-021-08653-1

Cited by 22 publications

(18 citation statements)

References 20 publications

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“…A total of 23 studies (n=1376) 11–33 reported the technical success of both procedures. The pooled technical success with PTBD and EUS-BD was 97.1% (95% CI: 95.6-98.5) and 96.9% (95% CI: 95.4-98.3), respectively.…”

Section: Resultsmentioning

confidence: 99%

“…Twenty-one studies (n=1181) 11,13–33 compared the technical success between EUS-BD and PTBD. The pooled clinical success with PTBD and EUS-BD was 78.4% (95% CI: 71.2-85.6) and 90.6% (95% CI: 86.4-94.8), respectively.…”

Section: Resultsmentioning

confidence: 99%

“…Figure 1 shows the PRISMA diagram for study screening and selection. Finally, 24 studies 11–34 were included in the meta-analysis. Table 1 summarizes the baseline characteristics of the included studies.…”

Section: Resultsmentioning

confidence: 99%

“…1A, Supplemental Digital Content 1, http://links.lww.com/SLE/A390). Of the nonrandomized studies, 1 had low risk, 32 15 had medium risk, 12,13,[16][17][18][19][20][21][22][23][24]26,29,30,33 and 4 had a high risk of bias 14,25,27,28 (Supplementary Fig. 1B, Supplemental Digital Content 1, http://links.lww.com/SLE/A390).…”

Section: Characteristics Of Included Studies and Quality Assessmentmentioning

confidence: 99%

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Endoscopic Ultrasound–guided Versus Percutaneous Transhepatic Biliary Drainage After Failed ERCP: A Systematic Review and Meta-analysis

Giri

Seth

Afzalpurkar³

et al. 2023

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Background: Endoscopic retrograde cholangiopancreatography (ERCP) may fail to achieve biliary drainage in 5% to 10% of cases. Endoscopic ultrasound–guided biliary drainage (EUS-BD) and percutaneous transhepatic biliary drainage (PTBD) are alternative therapeutic options in such cases. The present meta-analysis aimed to compare the efficacy and safety of EUS-BD and PTBD for biliary decompression after failed ERCP. Methods: A comprehensive search of literature from inception to September 2022 was done of 3 databases for studies comparing EUS-BD and PTBD for biliary drainage after failed ERCP. Odds ratios (ORs) with 95% CIs were calculated for all the dichotomous outcomes. Continuous variables were analyzed using mean difference (MD). Results: A total of 24 studies were included in the final analysis. Technical success was comparable between EUS-BD and PTBD (OR=1.12, 0.67-1.88). EUS-BD was associated with a higher clinical success rate (OR=2.55, 1.63-4.56) and lower odds of adverse events (OR=0.41, 0.29-0.59) compared with PTBD. The incidence of major adverse events (OR=0.66, 0.31-1.42) and procedure-related mortality (OR=0.43, 0.17-1.11) were similar between the groups. EUS-BD was associated with lower odds of reintervention with an OR of 0.20 (0.10-0.38). The duration of hospitalization (MD: −4.89, −7.73 to −2.05) and total treatment cost (MD: −1355.46, −2029.75 to −681.17) were significantly lower with EUS-BD. Conclusions: EUS-BD may be preferred over PTBD in patients with biliary obstruction after failed ERCP where appropriate expertise is available. Further trials are required to validate the findings of the study.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Characteristics Of Included Studies and Quality Assessmentmentioning

confidence: 99%

See 2 more Smart Citations

Endoscopic Ultrasound–guided Versus Percutaneous Transhepatic Biliary Drainage After Failed ERCP: A Systematic Review and Meta-analysis

Giri

Seth

Afzalpurkar³

et al. 2023

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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“…In fact, if it is shown that EUS-CDS is superior to ERCP, in terms of stent patency and safety, for the rstline drainage of MBO, it is expected that the rst-line BD method will be changed from ERCP to EUS-CDS, and that interruption of chemotherapy due to stent dysfunction could be avoided [9]. Additionally, even though percutaneous transhepatic BD (PTBD) may be considered as another alternative option after failed ERCP, some recent reports have claimed that EUS-BD with LAMS is superior to PTBD in terms of clinical success, safety, cost, and overall survival [24].…”

Section: Discussionmentioning

confidence: 99%

Multicenter Study of Lumen-apposing Metal Stents With or Without Pigtail in Endoscopic Ultrasound-guided Biliary Drainage for Malignant Obstruction- Bampi Trial: an Open-label, Randomized Controlled Trial Protocol.

García-Sumalla

Loras

Sánchiz

et al. 2022

Preprint

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Background: It is unclear whether the insertion of an axis-orienting double-pigtail plastic stent (DPS) through biliary lumen-apposing meal stent (LAMS) in EUS-guided choledochoduodenostomy (CDS) improves the stent patency. The aim of this study is to determine whether this technical variant offers a clinical benefit in EUS-guided biliary drainage (BD) for the management of distal malignant biliary obstruction.Methods/design: This is a multicenter open-label, randomized controlled trial with two parallel groups. Eighty-four patients with malignant biliary obstruction will undergo EUS-BD (CDS type) using LAMS in 7 tertiary hospitals in Spain and will be randomized to the LAMS and LAMS plus DPS groups. The primary endpoint is the rate of recurrent biliary obstruction, as a stent dysfunction parameter, detected during follow-up. Secondary endpoints: technical and clinical success (reduction in bilirubin >50% within 14 days of stent placement), safety, and others (number of reinterventions, time to biliary obstruction, prognostic factors, survival rate).Discussion: The BAMPI trial has been designed to determine whether the addition of a coaxial axis-orienting DPS through LAMS is superior to LAMS alone to prevent stent dysfunction. Trial registration: ClinicalTrials.gov, NCT04595058. Registered on October 14, 2020.

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Complications and management of interventional endoscopic ultrasound: A critical review

Fabbri,

Scalvini,

Paolo

et al. 2024

Best Practice & Research Clinical Gastroenterology

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EUS-guided biliary drainage with electrocautery-enhanced lumen-apposing metal stent placement should replace PTBD after ERCP failure in patients with distal tumoral biliary obstruction: a large real-life study

Cited by 22 publications

References 20 publications

Endoscopic Ultrasound–guided Versus Percutaneous Transhepatic Biliary Drainage After Failed ERCP: A Systematic Review and Meta-analysis

Endoscopic Ultrasound–guided Versus Percutaneous Transhepatic Biliary Drainage After Failed ERCP: A Systematic Review and Meta-analysis

Multicenter Study of Lumen-apposing Metal Stents With or Without Pigtail in Endoscopic Ultrasound-guided Biliary Drainage for Malignant Obstruction- Bampi Trial: an Open-label, Randomized Controlled Trial Protocol.

Complications and management of interventional endoscopic ultrasound: A critical review

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