Efficacy and Safety of EUS-Guided Choledochoduodenostomy Using Electrocautery-Enhanced Lumen-Apposing Metal Stents (ECE-LAMS) in the Treatment of Biliary Obstruction: A Systematic Review and Meta-Analysis
Background. Electrocautery-enhanced lumen-apposing metal stents (ECE-LAMS) have been newly developed to perform EUS-guided choledochoduodenostomy (EUS-CDS), but its benefits and harms remain obscure. We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of EUS-CDS us...
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| Language: | English |
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Wiley
2021-01-01
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| Series: | Canadian Journal of Gastroenterology and Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2021/6696950 |
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| author | Zuxiang Peng Shan Li Yongliang Tang Wanjie Wei Ruxian Pi Xianchun Liang Yafeng Wan Hongming Liu |
| author_facet | Zuxiang Peng Shan Li Yongliang Tang Wanjie Wei Ruxian Pi Xianchun Liang Yafeng Wan Hongming Liu |
| author_sort | Zuxiang Peng |
| collection | DOAJ |
| description | Background. Electrocautery-enhanced lumen-apposing metal stents (ECE-LAMS) have been newly developed to perform EUS-guided choledochoduodenostomy (EUS-CDS), but its benefits and harms remain obscure. We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of EUS-CDS using ECE-LAMS. Method. In the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), we searched PubMed, Embase, and Scopus databases through January 1, 2001, and April 27, 2020. The primary outcomes of the pooled analysis were to determine the technical success, clinical success, and overall adverse events rates. The secondary outcomes were pooled rates of short-term and long-term adverse events. Results. Six studies with 270 patients were finally included in this meta-analysis. The pooled rates of technical, clinical success, and adverse events were 95.1% (95% CI = 90.6–97.5%, I2 = 25%), 93.3% (95% CI = 87.4–96.5%, I2 = 28%), and 15.3% (95% CI = 10.6–21.6%, I2 = 13%), respectively. The pooled rates of short-term and long-term adverse events were 3.6% (95% CI = 1.3–9.6%, I2 = 0%) and 11.3% (95% CI = 7.6–16.5%, I2 = 0%), respectively. Conclusion. EUS-CDS using ECE-LAMS provides favorable outcomes in patients with biliary obstruction. It has been associated with a higher success rate and a lower rate of adverse events when compared with the biliary drainage approaches previously used. Large and randomized controlled observational studies are required to further refine the findings in the present analysis. |
| format | Article |
| id | doaj-art-3b719c692cc54b9193c7f61963a42a0e |
| institution | OA Journals |
| issn | 2291-2789 2291-2797 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
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| series | Canadian Journal of Gastroenterology and Hepatology |
| spelling | doaj-art-3b719c692cc54b9193c7f61963a42a0e2025-08-20T02:08:03ZengWileyCanadian Journal of Gastroenterology and Hepatology2291-27892291-27972021-01-01202110.1155/2021/66969506696950Efficacy and Safety of EUS-Guided Choledochoduodenostomy Using Electrocautery-Enhanced Lumen-Apposing Metal Stents (ECE-LAMS) in the Treatment of Biliary Obstruction: A Systematic Review and Meta-AnalysisZuxiang Peng0Shan Li1Yongliang Tang2Wanjie Wei3Ruxian Pi4Xianchun Liang5Yafeng Wan6Hongming Liu7Department of Hepatobiliary Surgery, Daping Hospital, Army Medical University, Chongqing, ChinaDepartment of Hepatobiliary Surgery, Daping Hospital, Army Medical University, Chongqing, ChinaDepartment of Hepatobiliary Surgery, Daping Hospital, Army Medical University, Chongqing, ChinaDepartment of Hepatobiliary Surgery, Daping Hospital, Army Medical University, Chongqing, ChinaDepartment of Hepatobiliary Surgery, Daping Hospital, Army Medical University, Chongqing, ChinaDepartment of Hepatobiliary Surgery, Daping Hospital, Army Medical University, Chongqing, ChinaDepartment of Hepatobiliary Surgery, Daping Hospital, Army Medical University, Chongqing, ChinaDepartment of Hepatobiliary Surgery, Daping Hospital, Army Medical University, Chongqing, ChinaBackground. Electrocautery-enhanced lumen-apposing metal stents (ECE-LAMS) have been newly developed to perform EUS-guided choledochoduodenostomy (EUS-CDS), but its benefits and harms remain obscure. We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of EUS-CDS using ECE-LAMS. Method. In the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), we searched PubMed, Embase, and Scopus databases through January 1, 2001, and April 27, 2020. The primary outcomes of the pooled analysis were to determine the technical success, clinical success, and overall adverse events rates. The secondary outcomes were pooled rates of short-term and long-term adverse events. Results. Six studies with 270 patients were finally included in this meta-analysis. The pooled rates of technical, clinical success, and adverse events were 95.1% (95% CI = 90.6–97.5%, I2 = 25%), 93.3% (95% CI = 87.4–96.5%, I2 = 28%), and 15.3% (95% CI = 10.6–21.6%, I2 = 13%), respectively. The pooled rates of short-term and long-term adverse events were 3.6% (95% CI = 1.3–9.6%, I2 = 0%) and 11.3% (95% CI = 7.6–16.5%, I2 = 0%), respectively. Conclusion. EUS-CDS using ECE-LAMS provides favorable outcomes in patients with biliary obstruction. It has been associated with a higher success rate and a lower rate of adverse events when compared with the biliary drainage approaches previously used. Large and randomized controlled observational studies are required to further refine the findings in the present analysis.http://dx.doi.org/10.1155/2021/6696950 |
| spellingShingle | Zuxiang Peng Shan Li Yongliang Tang Wanjie Wei Ruxian Pi Xianchun Liang Yafeng Wan Hongming Liu Efficacy and Safety of EUS-Guided Choledochoduodenostomy Using Electrocautery-Enhanced Lumen-Apposing Metal Stents (ECE-LAMS) in the Treatment of Biliary Obstruction: A Systematic Review and Meta-Analysis Canadian Journal of Gastroenterology and Hepatology |
| title | Efficacy and Safety of EUS-Guided Choledochoduodenostomy Using Electrocautery-Enhanced Lumen-Apposing Metal Stents (ECE-LAMS) in the Treatment of Biliary Obstruction: A Systematic Review and Meta-Analysis |
| title_full | Efficacy and Safety of EUS-Guided Choledochoduodenostomy Using Electrocautery-Enhanced Lumen-Apposing Metal Stents (ECE-LAMS) in the Treatment of Biliary Obstruction: A Systematic Review and Meta-Analysis |
| title_fullStr | Efficacy and Safety of EUS-Guided Choledochoduodenostomy Using Electrocautery-Enhanced Lumen-Apposing Metal Stents (ECE-LAMS) in the Treatment of Biliary Obstruction: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Efficacy and Safety of EUS-Guided Choledochoduodenostomy Using Electrocautery-Enhanced Lumen-Apposing Metal Stents (ECE-LAMS) in the Treatment of Biliary Obstruction: A Systematic Review and Meta-Analysis |
| title_short | Efficacy and Safety of EUS-Guided Choledochoduodenostomy Using Electrocautery-Enhanced Lumen-Apposing Metal Stents (ECE-LAMS) in the Treatment of Biliary Obstruction: A Systematic Review and Meta-Analysis |
| title_sort | efficacy and safety of eus guided choledochoduodenostomy using electrocautery enhanced lumen apposing metal stents ece lams in the treatment of biliary obstruction a systematic review and meta analysis |
| url | http://dx.doi.org/10.1155/2021/6696950 |
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