Abstract:
BACKGROUND:Anastomotic biliary strictures (ABSs) are common after liver transplantation, especially with living donors. The strategy of balloon dilation and multiple plastic stents (MPSs) is effective in treating ABSs, but requires multiple ERCPs with the associated risks, cost, and patient burden. Covered self-expandable metal stents (SEMSs) have been increasingly used in this setting. However, it is not clear whether there are definite advantages of using SEMSs over MPSs. OBJECTIVE:To compare the efficacy and safety of MPSs and SEMSs in ABS after orthotopic liver transplantation (OLT) and living donor liver transplantation (LDLT). DESIGN:Systematic review by searching MEDLINE and EMBASE databases. PATIENTS:OLT and LDLT patients. INTERVENTIONS:MPSs versus SEMSs. MAIN OUTCOME MEASUREMENTS:Stricture resolution and adverse event rates. RESULTS:Eight studies (446 patients) using MPSs in OLT, 3 studies (120 patients) using MPSs in LDLT, and 10 studies (200 patients) using SEMSs fulfilled the inclusion and exclusion criteria. The stricture resolution rates were highest (94%-100%) when MPS duration was 12 months or longer. The stricture resolution rates with SEMSs in OLT patients were also high when stent duration was 3 months or longer (80%-95%) compared with a duration less than 3 months (53%-88%). Although the overall adverse event rates were low, the overall SEMS migration rate was significant at 16%. LIMITATIONS:No randomized, controlled trials were identified; only small case series using either MPSs or SEMSs were included. CONCLUSIONS:Although SEMSs appeared to be a promising option in the endoscopic management of ABSs after liver transplantation, current evidence does not suggest a clear advantage of SEMS use over MPSs for this indication.
journal_name
Gastrointest Endoscjournal_title
Gastrointestinal endoscopyauthors
Kao D,Zepeda-Gomez S,Tandon P,Bain VGdoi
10.1016/j.gie.2013.01.015subject
Has Abstractpub_date
2013-05-01 00:00:00pages
679-91issue
5eissn
0016-5107issn
1097-6779pii
S0016-5107(13)00031-Xjournal_volume
77pub_type
杂志文章,评审abstract:BACKGROUND:EUS-FNA can be used to accurately diagnose and stage GI and pulmonary neoplasms. This study evaluated the performance characteristics of a new compact linear EUS system during EUS-FNA. METHODS:A total of 37 patients enrolled in this prospective pilot study underwent clinically indicated EUS-FNA and/or celia...
journal_title:Gastrointestinal endoscopy
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doi:10.1016/j.gie.2008.03.1062
更新日期:2008-10-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究
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更新日期:2007-08-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章
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更新日期:1998-09-01 00:00:00
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journal_title:Gastrointestinal endoscopy
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
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更新日期:1987-08-01 00:00:00
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更新日期:2001-08-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/s0016-5107(95)70042-0
更新日期:1995-11-01 00:00:00
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更新日期:1988-11-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(97)70266-9
更新日期:1997-03-01 00:00:00
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journal_title:Gastrointestinal endoscopy
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doi:10.1016/j.gie.2007.06.017
更新日期:2007-09-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/s0016-5107(84)72419-9
更新日期:1984-10-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2006-04-01 00:00:00
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更新日期:1990-01-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2010-07-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2019-07-01 00:00:00
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pub_type: 杂志文章
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更新日期:2010-09-01 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章
doi:10.1016/j.gie.2007.02.042
更新日期:2007-10-01 00:00:00
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pub_type: 杂志文章
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更新日期:1999-04-01 00:00:00
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更新日期:2001-08-01 00:00:00
abstract:BACKGROUND:Biliary complications are the second leading cause of morbidity and mortality in orthotopic liver transplant (OLT) recipients. Endoscopic retrograde cholangiography (ERC) is considered the diagnostic criterion standard for post-orthotopic liver transplantation biliary obstruction, but incurs significant risk...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,meta分析,评审
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更新日期:2011-05-01 00:00:00
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pub_type: 杂志文章
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更新日期:2001-04-01 00:00:00