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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 | 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 |
| 3 | Effect of spray-dried plamaa and fructooligosaccharide on nursery performance and small intestinal morphology of weaned pgs显示文摘 | Spencer J D Touchette K J Liu H | 1997 | J Anim Sci1997，75，1： | 1 |
| 4 | Transbronchial biopsies provide longitudinal evidence for epithelial chimerism in children following sex mismatched lung transplantation显示文摘 | SPENCER H RAMPLING D AURORA P | 2005 | Thorax2005，60，1： | 1 |
| 5 | Mitigation of dense gas releases in buildings: use of simple models显示文摘 | DEAVES D M GILHAM S SPENCER H | 2000 | Journal of Hazardous Materials2000，，71： | 1 |
| 6 | Pol J Chem 显示文摘 | Iawska D Yang J - Z Spencer H G | 1995 | 69 : 1527 - 301995，69，： | 1 |
| 7 | Contrasting influences of glucuronidation and O-methylation of epicatechin on hydrogen peroxide-induced cell death in neurons and fibroblasts显示文摘 | SPENCER J P SCHROETER H CROSSTHWAITHE A J | 2001 | Free Radic Biol Med2001，31，9： | 1 |
| 8 | A randomized clinical trial of inpatient family intervention,lII:effects at 6-month and 18 -month follow-ups 显示文摘 | Spencer J H Glick I D Haas G L | 1988 | Am J Psychiatry1988，145，9： | 1 |
| 9 | Zero-forcing Methods for Downlink Spatial Multiplexing in Multiuser MIMO Channels显示文摘 | Spencer Q H Swindlehurst A L Haardt M | 2004 | IEEE Trans on Signal Processing2004，52，2： | 1 |
| 10 | First-trimester maternal placental protein 13 levels in pregnancies resulting in adverse outcomes显示文摘 | COWANS N J SPENCER K MEIRI H | 2008 | Prenat Diagn2008，28，2： | 1 |
| 11 | Isolation and characterization of an anti-HSV polysaccharides from Prunella vulgaris显示文摘 | XU H X SPENCER H S L SONG F L | 1999 | Antiviral Research1999，44，： | 1 |
| 12 | Isolation system for vibration control of stay cables显示文摘 | Inho H Jong S L Jr Spencer B F | 2009 | Journal of Engineering Mechanics2009，135，1： | 1 |
| 13 | Dynamic formation of a self- formed membrane by nanofiltration of a high - forinca - weight dye显示文摘 | Xu X T Caddis J L Spencer H G | 2000 | Desalination2000，129，： | 1 |
| 14 | Benchmark problems in structural control part I:Active mass driver system 显示文摘 | SPENCER B F Jr DYKE S J DEOSKAR H S | 1998 | Earthquake Engineering and Structural Dynamics1998，27，11： | 1 |
| 15 | “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 |
| 16 | State-of-the-art of semiactive control systems using MR fluid dampers in civil engineering applications显示文摘 | Jung H J Spencer B F Jr Ni Y Q | 2004 | Structural Engineering and Mechanics2004，17，34： | 1 |
| 17 | Dynamic model- ing of large - scale mageto theological damper systems for civil engineering applications 显示文摘 | Yang G Q Spencer B F June H J | 2004 | Journal of Engineering Mechanics2004，130，9： | 1 |
| 18 | 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 |
| 19 | Zero-forcing methods for downlink spatial multiplexing in multiuser MIMO channels显示文摘 | QUENTIN H SPENCER A LEE S A | 2004 | IEEE Transactions on Signal Processing2004，52，2： | 1 |
| 20 | Zero-forcing methods for downlink spatial muhiplexing in multiuser MIMO channels显示文摘 | Spencer Q H Swindlehurst A L Haardt M | 2004 | IEEE Transactions on Signal Processing2004，52，2： | 1 |
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