PMID- 30648136
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200930
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 7
IP  - 1
DP  - 2019 Jan
TI  - Endoscopic biliary self-expandable metallic stent in malignant biliary 
      obstruction with or without sphincterotomy: systematic review and meta-analysis.
PG  - E26-E35
LID - 10.1055/a-0752-9956 [doi]
AB  - Background and aim  To assess the rate of adverse events and the technical 
      success rate of biliary stenting with or without EBS.  Methods  A literature 
      search up to February 2017 was performed. Studies assessing adverse events (AEs) 
      and technical success rates of stenting with or without EBS were considered. 
      Results  Seven studies (870 patients; 12 treatment arms) were included. Early 
      AEs, i. e. those occurring within 30 days, were significantly lower in no-EBS vs. 
      EBS-group (11 % vs . 20.1 %; OR: 0.36, 95 %CI: 0.13 - 1.00). Rates of 
      post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis were not 
      significantly different in the two groups (no-EBS vs . EBS: 6.1 % vs 5 %; OR: 
      1.33, 95 %CI: 0.68 - 2.59). The rate of bleeding was significantly lower in 
      patients without EBS (no-EBS vs EBS: 0 % vs 5 %; OR: 0.12, 95 % CI: 0.03 - 0.45). 
      Rates of cholangitis were significantly lower in patients without EBS (no-EBS vs 
      . EBS: 3.3 % vs. 7.4 %; OR: 0.38, 95 %CI: 0.17 - 0.83). Both late AEs and 
      mortality rates did not significantly differ between no-EBS and EBS patients 
      (19.9 % vs. 18.9 %; OR: 0.93, 95 %CI: 0.56 - 1.53, and 2.5 % vs. 2.9 %; OR: 1.18, 
      95 %CI: 0.22 - 6.29, respectively). The technical success rate for stent 
      insertion also did not differ (98 % vs. 97.6 %; OR: 1.05, 95 %CI: 0.42 - 2.63). 
      Conclusion  EBS seems to be associated, in the first 30 days after the procedure, 
      with an increased risk of cholangitis and bleeding. No difference was observed in 
      the rate of post-ERCP pancreatitis.
FAU - Mangiavillano, Benedetto
AU  - Mangiavillano B
AD  - Gastrointestinal Endoscopy Unit; Humanitas - Mater Domini Castellanza, Italy.
AD  - Humanitas University, Milan, Italy.
FAU - Montale, Amedeo
AU  - Montale A
AD  - Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, 
      Bologna, Italy.
FAU - Frazzoni, Leonardo
AU  - Frazzoni L
AD  - Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, 
      Bologna, Italy.
FAU - Bianchetti, Mario
AU  - Bianchetti M
AD  - Gastrointestinal Endoscopy Unit; Humanitas - Mater Domini Castellanza, Italy.
FAU - Sethi, Amrita
AU  - Sethi A
AD  - New York-Presbyterian Medical Center/Columbia University Medical Center, New 
      York, New York, United States.
FAU - Repici, Alessandro
AU  - Repici A
AD  - Humanitas University, Milan, Italy.
AD  - Digestive Endoscopy Unit, Humanitas Research Hospital, Rozzano (MI) Italy.
FAU - Fuccio, Lorenzo
AU  - Fuccio L
AD  - Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, 
      Bologna, Italy.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20190103
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC6327725
COIS- Competing interests None
EDAT- 2019/01/17 06:00
MHDA- 2019/01/17 06:01
PMCR- 2019/01/01
CRDT- 2019/01/17 06:00
PHST- 2018/05/11 00:00 [received]
PHST- 2018/09/04 00:00 [accepted]
PHST- 2019/01/17 06:00 [entrez]
PHST- 2019/01/17 06:00 [pubmed]
PHST- 2019/01/17 06:01 [medline]
PHST- 2019/01/01 00:00 [pmc-release]
AID - 10.1055/a-0752-9956 [doi]
PST - ppublish
SO  - Endosc Int Open. 2019 Jan;7(1):E26-E35. doi: 10.1055/a-0752-9956. Epub 2019 Jan 
      3.