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Endoscopic ultrasound-guided biliary drainage versus percutaneous transhepatic biliary drainage after failed endoscopic retrograde cholangiopancreatography: a meta-analysis

Authors Baniya R, Upadhaya S, Madala S, Subedi SC, Shaik Mohammed T, Bachuwa G

Received 9 January 2017

Accepted for publication 5 March 2017

Published 3 April 2017 Volume 2017:10 Pages 67—74

DOI https://doi.org/10.2147/CEG.S132004

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Lucy Goodman

Peer reviewer comments 2

Editor who approved publication: Professor Andreas M Kaiser


Ramkaji Baniya, Sunil Upadhaya, Seetharamprasad Madala, Subash Chandra Subedi, Tabrez Shaik Mohammed, Ghassan Bachuwa

Hurley Medical Center, Michigan State University, Flint, MI, USA

Abstract:
The failure rate of endoscopic retrograde cholangiopancreatography for biliary cannulation is approximately 6%–7% in cases of obstructive jaundice. Percutaneous transhepatic biliary drainage (PTBD) is the procedure of choice in such cases. Endoscopic ultrasound-guided biliary drainage (EGBD) is a novel technique that allows biliary drainage by echoendoscopy and fluoroscopy using a stent from the biliary tree to the gastrointestinal tract. Information in PubMed, Scopus, clinicaltrials.gov and Cochrane review were analyzed to obtain studies comparing EGBD and PTBD. Six studies fulfilled the inclusion criteria. Technical (odds ratio (OR): 0.34; confidence interval (CI) 0.10–1.14; p=0.05) and clinical (OR: 1.48; CI 0.46–4.79; p=0.51) success rates were not statistically significant between the EGBD and PTBD groups. Mild adverse events were nonsignificantly different (OR: 0.36; CI 0.10–1.24; p=0.11) but not the moderate-to-severe adverse events (OR: 0.16; CI 0.08–0.32; p≤0.00001) and total adverse events (OR: 0.34; CI 0.20–0.59; p≤0.0001). EGBD is equally effective but safer than PTBD.

Keywords: failed endoscopic retrograde cholangiopancreatography, percutaneous transhepatic biliary drainage, endoscopic ultrasound-guided biliary drainage, technical success, clinical success

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