PMID- 37744320
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230926
IS  - 1948-5190 (Print)
IS  - 1948-5190 (Electronic)
VI  - 15
IP  - 9
DP  - 2023 Sep 16
TI  - Comparison of trans-gastric vs trans-enteric (trans-duodenal or trans-jejunal) 
      endoscopic ultrasound guided gallbladder drainage using lumen apposing metal 
      stents.
PG  - 574-583
LID - 10.4253/wjge.v15.i9.574 [doi]
AB  - BACKGROUND: Endoscopic ultrasound guided gallbladder drainage (EUS-GBD) is being 
      increasingly used in practice (either as a bridge to cholecystectomy in high-risk 
      patients or as destination therapy in non-surgical patients). Stents are used to 
      create a conduit between the lumen of the gallbladder (GB) and the intestinal 
      lumen through the gastric or enteric routes. Among the various types of stents 
      used, cautery-enhanced lumen apposing metallic stents (LAMS) may be associated 
      with fewer adverse events (AEs). AIM: To compare the clinical success, technical 
      success, and rate of AEs between transgastric (TG) and trans-enteric 
      [transduodenal (TD)/transjejunal (TJ)] approach to GB drainage. Further, we 
      analyzed whether using cautery enhanced stents during EUS-GBD impacts the above 
      parameters. METHODS: Study was registered in PROSPERO (CRD42022319019) and 
      comprehensive literature review was conducted. Manuscripts were reviewed for the 
      data collection: Rate of AEs, clinical success, and technical success. Random 
      effects model was utilized for the analysis. RESULTS: No statistically 
      significant difference in clinical and technical success between the TD/TJ and TG 
      approaches (P > 0.05) were noted. There was no statistically significant 
      difference in the rate of AEs when comparing two-arm studies only. However, when 
      all studies were included in the analysis difference was almost significant 
      favoring the TD/TJ approach. When comparing cautery-enhanced LAMS with 
      non-cautery enhanced LAMS, a statistically significant difference in the rate of 
      AEs was observed when all the studies were included, with the rate being higher 
      in non-cautery enhanced stents (14.0% vs 37.8%; P < 0.01). CONCLUSION: As per our 
      study results, TD/TJ approach appears to be associated with lower rate of adverse 
      events and comparable efficacy when compared to the TG approach for the EUS-GBD. 
      Additionally, use of cautery-enhanced LAMS for EUS-GBD is associated with a more 
      favorable adverse event profile compared to cold LAMS. Though the approach chosen 
      depends on several patient and physician factors, the above findings could help 
      in deciding the ideal drainage route when both TG and TD/TJ approaches are 
      feasible.
CI  - (c)The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights 
      reserved.
FAU - Grover, Dheera
AU  - Grover D
AD  - Department of Internal Medicine, University of Connecticut, Farmington, CT 06030, 
      United States.
FAU - Fatima, Ifrah
AU  - Fatima I
AD  - Department of Internal Medicine, University of Missouri-Kansas City, Kansas City, 
      MO 64110, United States.
FAU - Dharan, Murali
AU  - Dharan M
AD  - Department of Gastroenterology and Hepatology, University of Connecticut Health 
      Center, Farmington, CT 06030, United States. dharan@uchc.edu.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - World J Gastrointest Endosc
JT  - World journal of gastrointestinal endoscopy
JID - 101532474
PMC - PMC10514705
OTO - NOTNLM
OT  - AXIOS
OT  - Cautery
OT  - Endoscopic ultrasound guided gallbladder drainage
OT  - Transduodenal
OT  - Transgastric
COIS- Conflict-of-interest statement: All co-authors of this manuscript confirm that 
      there are no financial or personal relationships with any people or organizations 
      that could inappropriately influence the actions of any author of this 
      manuscript.
EDAT- 2023/09/25 06:43
MHDA- 2023/09/25 06:44
PMCR- 2023/09/16
CRDT- 2023/09/25 04:42
PHST- 2023/03/20 00:00 [received]
PHST- 2023/07/25 00:00 [revised]
PHST- 2023/08/23 00:00 [accepted]
PHST- 2023/09/25 06:44 [medline]
PHST- 2023/09/25 06:43 [pubmed]
PHST- 2023/09/25 04:42 [entrez]
PHST- 2023/09/16 00:00 [pmc-release]
AID - 10.4253/wjge.v15.i9.574 [doi]
PST - ppublish
SO  - World J Gastrointest Endosc. 2023 Sep 16;15(9):574-583. doi: 
      10.4253/wjge.v15.i9.574.