PMID- 37392952
OWN - NLM
STAT- MEDLINE
DCOM- 20230925
LR  - 20231027
IS  - 1097-6779 (Electronic)
IS  - 0016-5107 (Linking)
VI  - 98
IP  - 4
DP  - 2023 Oct
TI  - Adverse events with EUS-guided biliary drainage: a systematic review and 
      meta-analysis.
PG  - 515-523.e18
LID - S0016-5107(23)02706-2 [pii]
LID - 10.1016/j.gie.2023.06.055 [doi]
AB  - BACKGROUND AND AIMS: Multiple meta-analyses have evaluated the technical and 
      clinical success of EUS-guided biliary drainage (BD), but meta-analyses 
      concerning adverse events (AEs) are limited. The present meta-analysis analyzed 
      AEs associated with various types of EUS-BD. METHODS: A literature search of 
      MEDLINE, Embase, and Scopus was conducted from 2005 to September 2022 for studies 
      analyzing the outcome of EUS-BD. The primary outcomes were incidence of overall 
      AEs, major AEs, procedure-related mortality, and reintervention. The event rates 
      were pooled using a random-effects model. RESULTS: One hundred fifty-five studies 
      (7887 patients) were included in the final analysis. The pooled clinical success 
      rates and incidence of AEs with EUS-BD were 95% (95% confidence interval [CI], 
      94.1-95.9) and 13.7% (95% CI, 12.3-15.0), respectively. Among early AEs, bile 
      leak was the most common followed by cholangitis with pooled incidences of 2.2% 
      (95% CI, 1.8-2.7) and 1.0% (95% CI, .8-1.3), respectively. The pooled incidences 
      of major AEs and procedure-related mortality with EUS-BD were .6% (95% CI, .3-.9) 
      and .1% (95% CI, .0-.4), respectively. The pooled incidences of delayed migration 
      and stent occlusion were 1.7% (95% CI, 1.1-2.3) and 11.0% (95% CI, 9.3-12.8), 
      respectively. The pooled event rate for reintervention (for stent migration or 
      occlusion) after EUS-BD was 16.2% (95% CI, 14.0-18.3; I(2) = 77.5%). CONCLUSIONS: 
      Despite a high clinical success rate, EUS-BD may be associated with AEs in 
      one-seventh of the cases. However, major AEs and mortality incidence remain less 
      than 1%, which is reassuring.
CI  - Copyright (c) 2023 American Society for Gastrointestinal Endoscopy. Published by 
      Elsevier Inc. All rights reserved.
FAU - Giri, Suprabhat
AU  - Giri S
AD  - Department of Gastroenterology, Nizam's Institute of Medical Sciences, Hyderabad, 
      India.
FAU - Mohan, Babu P
AU  - Mohan BP
AD  - Department of Gastroenterology, University of Utah, Salt Lake City, Utah, USA.
FAU - Jearth, Vaneet
AU  - Jearth V
AD  - Department of Gastroenterology, Post Graduate Institute of Medical Education & 
      Research, Chandigarh, India.
FAU - Kale, Aditya
AU  - Kale A
AD  - Department of Gastroenterology, Seth GS Medical College and KEM Hospital, Mumbai, 
      India.
FAU - Angadi, Sumaswi
AU  - Angadi S
AD  - Department of Gastroenterology, Nizam's Institute of Medical Sciences, Hyderabad, 
      India.
FAU - Afzalpurkar, Shivaraj
AU  - Afzalpurkar S
AD  - Department of Gastroenterology, Nanjappa Multispecialty Hospital, Davanagere, 
      India.
FAU - Harindranath, Sidharth
AU  - Harindranath S
AD  - Department of Gastroenterology, Seth GS Medical College and KEM Hospital, Mumbai, 
      India.
FAU - Sundaram, Sridhar
AU  - Sundaram S
AD  - Department of Digestive Diseases and Clinical Nutrition, Tata Memorial Hospital, 
      Homi Bhabha National Institute, Mumbai, India.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20230629
PL  - United States
TA  - Gastrointest Endosc
JT  - Gastrointestinal endoscopy
JID - 0010505
SB  - IM
MH  - Humans
MH  - *Cholestasis/etiology/surgery
MH  - Endosonography/adverse effects
MH  - *Cholangitis
MH  - Drainage/adverse effects
MH  - Stents/adverse effects
MH  - Cholangiopancreatography, Endoscopic Retrograde/adverse effects
COIS- Disclosure All authors disclosed no financial relationships.
EDAT- 2023/07/02 01:10
MHDA- 2023/09/25 06:42
CRDT- 2023/07/01 19:15
PHST- 2023/02/06 00:00 [received]
PHST- 2023/06/01 00:00 [revised]
PHST- 2023/06/20 00:00 [accepted]
PHST- 2023/09/25 06:42 [medline]
PHST- 2023/07/02 01:10 [pubmed]
PHST- 2023/07/01 19:15 [entrez]
AID - S0016-5107(23)02706-2 [pii]
AID - 10.1016/j.gie.2023.06.055 [doi]
PST - ppublish
SO  - Gastrointest Endosc. 2023 Oct;98(4):515-523.e18. doi: 10.1016/j.gie.2023.06.055. 
      Epub 2023 Jun 29.