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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 | Clostridium difficile Enteritis after Colectomy显示文摘 | Causey M Wayne Spencer Michael P Steele Scott R | 2009 | The American Surgeon2009，，12： | 2 |
| 3 | Modeling and control of magnetorheological dampers forseismic response reduction 显示文摘 | DYKE S J SPENCER B F SAIN M K CARLSON J D | 1996 | Smart Materials and Structures1996，5，5： | 2 |
| 4 | Thalidomide in the management of multiple myeloma显示文摘 | Barlogie B Zangari M Spencer T | | 0，，： | 2 |
| 5 | Simulation of Packing Density and Liquid Flow in Fixed Beds 显示文摘 | Spedding P L Spencer R M | 1995 | Computers and Chemical Engineering1995，19，： | 1 |
| 6 | 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 |
| 7 | 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 |
| 8 | Helper (CD4^+ )and Cytotoxic (CD8^+ ) T Cells Promote the Pathology of Dystrophin-Defieient Muscle显示文摘 | Spencer M J Montecino Rodriquez E Dorshkind K | 2001 | Clin Immunol2001，98，2： | 1 |
| 9 | 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 |
| 10 | Phenomenological model d a magnetorheological damper ASCE 显示文摘 | Spencer Jr B F Dyke S J Sain M K | 1997 | Journal of Engineering Mechanics1997，123，3： | 1 |
| 11 | Transformation of Maize Calls and Regeneration of Fertile Transgenic Plants显示文摘 | Gordon-Kamm W J Spencer T M Mangano M L | 1990 | The Plant Cell1990，2，7： | 1 |
| 12 | Thalidomide in the management of multiple myeloma 显示文摘 | BARLOGIC B ZANGARI M SPENCER T | 2001 | Semin Hematol2001，38，： | 1 |
| 13 | Phenomenological model of a magnetorheological damper显示文摘 | Spencer B F Dyke S J Sain M K | 1997 | Journal of the Engineering Mechanics ASCE Journal of Engineering Mechanics1997，123，3： | 1 |
| 14 | Phenomenological model for magnetorheological damper显示文摘 | Spencer Jr B F Dyke S J Sain M K | 1997 | ASCE J Eng Mech1997，123，3： | 1 |
| 15 | 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 |
| 16 | Adenosine: a potential mediator of seizure arrest and postictal refractoriness显示文摘 | During M J Spencer DD | 1992 | Ann Neurol1992，32，5： | 1 |
| 17 | Temporal lobe tumoral epilepsy Characteristics and predictors of surgical outcome显示文摘 | Zaatreh M M Firlik K S Spencer D D | 2003 | Neurology2003，61，5： | 1 |
| 18 | An experimental study of magnetorheological dampers for seismic protection 显示文摘 | Dyke S J Spencer B F Sain M K | 1998 | Smart Mater Struct1998，7，： | 1 |
| 19 | Endogenous betaretroviruses of sheep: teaching new lessons in retroviral interference and adaptation显示文摘 | PALMARINI M MURA M SPENCER T E | 2004 | J Gen Virol2004，85，1： | 1 |
| 20 | Do Immune Cells Promote the Pathology of Dystrophin-Deficient Myopathies显示文摘 | Spencer M J Tidball J G | 2001 | Neuromuscul Disord2001，11，67： | 1 |
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