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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 | Mice lacking nerve growth factor display perinatal loss of sensory and sympathetic neurons yet develop basal forebrain chlinergic neurons显示文摘 | Crouley C Spencer SD Nishimura MC | 1994 | Cell1994，76，16： | 1 |
| 3 | Periodic orbits in the restricted four-body problem显示文摘 | Howell K C Spencer D B | 1986 | Acta Astronautica1986，13，8： | 1 |
| 4 | Probabilistic stability measures for controlled structures subject to the real parameter uneertainties显示文摘 | SPENCER JR B F SAIN M K KANOR J C | 1992 | Smart Materials and Structures1992，1，2： | 1 |
| 5 | Development and testing of a rapid appraisal wetland condition index in southeastern Australia显示文摘 | SPENCER C ROBERTSON A I CURTIS A | 1998 | Environmental Management1998，54，2： | 1 |
| 6 | Astrocytes and epilepsy 显示文摘 | De-Lanerolle N C Lee T S Spencer D D | 2010 | Neurotherapeutics2010，7，4： | 1 |
| 7 | Von Willebrand Factor,Soluble P-selectin,and Target Organ Damage in Hypertension:A Substudy of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT)显示文摘 | Spencer C G Gurney D Blann A D | 2002 | Hypertension2002，40，： | 1 |
| 8 | Role of γδ cells in murine collagen-induced arthritis显示文摘 | Spencer C Sperling A | 1993 | J Immunol1993，151，11： | 1 |
| 9 | Role of FGF10/FGFR2b signaling during mammary gland development in the mouse embryo 显示文摘 | Mailleux AA Spencer - Dene B Dillon C | 2002 | Development2002，129，1： | 1 |
| 10 | “Smart”base isolation strategies employing magnetorheological damper显示文摘 | Yoshida H Ramallo J C Spencer J B F | 2002 | Journal of Engineering Mechanics(ASCE)2002，128，5： | 1 |
| 11 | Pilot fatigue in short-haul operations : effects of number of sectors, duty length, and time of day显示文摘 | Powell D M C Spencer M B Holland D | 2007 | Aviation Space and Environmental Medicine2007，78，7： | 1 |
| 12 | Radical vaginal trachelectomy as a fertility-sparing procedure in women with early-stage cervical cancer-cumulative pregnancy rate in a series of 123 women显示文摘 | Shepherd JH Spencer C Herod J | 2006 | BJOG2006，113，6： | 1 |
| 13 | Malposition of transvenous pacing lead in the left ventricle显示文摘 | RAGHAVAN C CASHION JR W R SPENCER Ⅲ W H | 1996 | Clin Cardiol1996，19，4： | 1 |
| 14 | Review of characteristics of low - permea- bility gas reservoirs in western United States显示文摘 | Spencer C W | 1989 | AAPG Bulletin1989，73，5： | 1 |
| 15 | 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 |
| 16 | Flavonoids protect neurons from oxidized low-density-lipoprotein-induced apoptosis involving c-Jun N-terminal kinase (JNK), c-Jun and caspase-3 显示文摘 | SCHROETER H SPENCER JPE RICE-EVANS C | 2001 | Biochem J2001，358，3： | 1 |
| 17 | Growth hormone receptor and serum binding protein : purification, cloning and expression 显示文摘 | Leung D W Spencer S A Cachianes G Hammonds R G Collins C Henzel W J Bamant R Waters M J Wood W I | 1987 | Nature1987，330，： | 1 |
| 18 | Review of characteristics of low-permeability gas reservoirs in Western United States显示文摘 | Spencer C W | 1989 | AAPG Bulletin1989，73，5： | 1 |
| 19 | Estimates of gene flow in Eichhornia paniculata ( Pontederiaceae ) : e f fects of range substructure显示文摘 | Brian C Husband Spencer C H Barrett | 1995 | Heredity1995，75，： | 1 |
| 20 | Futher studies of the effect of zinc on intestinal absorption of calcium in man显示文摘 | Norris C Osis D | 1992 | J Am Col Nutr1992，11，5： | 1 |
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