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Is Endoscopic Ultrasound-Guided Hepaticogastrostomy Safe and Effective after Failed Endoscopic Retrograde Cholangiopancreatography?—A Systematic Review and Meta-Analysis
- Source :
- Journal of Clinical Medicine, Vol 13, Iss 13, p 3883 (2024)
- Publication Year :
- 2024
- Publisher :
- MDPI AG, 2024.
-
Abstract
- Background/Objectives: Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) has emerged as an alternative option for biliary drainage in cases of failed endoscopic retrograde cholangiopancreatography (ERCP). Limited data exist on the safety and efficacy of EUS-HGS. In this comprehensive meta-analysis, we aim to study the safety and efficacy of EUS-HGS in cases of failed conventional ERCP. Methods: Embase, PubMed, and Web of Science databases were searched to include all studies that evaluated the efficacy and safety of EUS-HGS. Using the random effect model, the pooled weight-adjusted event rate estimate for clinical outcomes in each group were calculated with 95% confidence intervals (CIs). The primary outcomes were technical and clinical success rates. Secondary outcomes included overall adverse events (AEs), rates of recurrent biliary obstruction (RBO), and rates or re-intervention. Results: Our analysis included 70 studies, with a total of 3527 patients. The pooled technical and clinical success rates for EUS-HGS were 98.1% ([95% CI, 97.5–98.7]; I2 = 40%) and 98.1% ([95% CI, 97.5–98.7]; I2 = 40%), respectively. The pooled incidence rate of AEs with EUS-HGS was 14.9% (95% CI, 12.7–17.1), with bile leakage being the most common (2.4% [95% CI, 1.7–3.2]). The pooled incidence of RBO was 15.8% [95% CI, 12.2–19.4], with a high success rate for re-intervention (97.5% [95% CI, 94.7–100]). Conclusions: Our analysis showed high technical and clinical success rates of EUS-HGS, making it a feasible and effective alternative to ERCP. The ongoing development of dedicated devices and techniques is expected to make EUS-HGS more accessible and safer for patients in need of biliary drainage.
Details
- Language :
- English
- ISSN :
- 20770383
- Volume :
- 13
- Issue :
- 13
- Database :
- Directory of Open Access Journals
- Journal :
- Journal of Clinical Medicine
- Publication Type :
- Academic Journal
- Accession number :
- edsdoj.b7f2ba6c2b3f436faf49cdda534d7dd8
- Document Type :
- article
- Full Text :
- https://doi.org/10.3390/jcm13133883