Abstract:
BACKGROUND AND AIMS:Unresectable malignant biliary strictures are generally managed by palliative stent placement for drainage of biliary tree. Recently, radiofrequency ablation (RFA) has been used to improve the patency of biliary stents in these patients. Several studies have evaluated the effectiveness of biliary stent placement with RFA on stent patency and patient survival with variable results. We performed this meta-analysis to evaluate the efficacy and safety of biliary stent placement with RFA compared with stent placement alone in patients with malignant biliary strictures. METHODS:We performed a comprehensive search of electronic databases for all studies comparing RFA with biliary stent placement versus stent placement only. Measured outcomes included patient survival, stent patency, and procedure-related adverse events. An inverse variance method was used to pool data on stent patency into a random-effects model. Cox-regression analysis was used to calculate hazard ratio for survival analysis. We used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework to interpret our findings. RESULTS:Nine studies (including 2 abstracts) with a total of 505 patients were included in the meta-analysis. The pooled weighted mean difference in stent patency was 50.6 days (95% confidence interval [CI], 32.83-68.48), favoring patients receiving RFA. Pooled survival analysis of the reconstructed Kaplan-Meier data showed improved survival in patients treated with RFA (hazard ratio, 1.395; 95% CI, 1.145-1.7; P < .001). However, RFA was associated with a higher risk of postprocedural abdominal pain (31% vs 20%, P = .003). Our analysis did not show significant difference between the RFA and stent placement-only groups with regard to the risk of cholangitis, acute cholecystitis, pancreatitis, and hemobilia. CONCLUSIONS:In the light of this limited data based on observational studies, RFA was found to be safe and was associated with improved stent patency in patients with malignant biliary strictures. In addition, RFA may be associated with improved survival in these patients.
journal_name
Gastrointest Endoscjournal_title
Gastrointestinal endoscopyauthors
Sofi AA,Khan MA,Das A,Sachdev M,Khuder S,Nawras A,Lee Wdoi
10.1016/j.gie.2017.10.029subject
Has Abstractpub_date
2018-04-01 00:00:00pages
944-951.e1issue
4eissn
0016-5107issn
1097-6779pii
S0016-5107(17)32426-4journal_volume
87pub_type
杂志文章,meta分析,评审abstract:BACKGROUND:Endoscopic biliary sphincterotomy (EST) is a well-established procedure for bile duct stone extraction. Bile duct stones can be classified as primary or secondary. However, few data are available on the recurrence of primary and secondary bile duct stones after EST. Therefore risk factors for the recurrence ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2001.115335
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND:Barrett's epithelium is a risk factor for esophageal cancer. In this study we attempted to reverse Barrett's epithelium in an acid-reduced environment by using multipolar electrocoagulation. METHODS:All patients had specialized columnar epithelium of at least 2 cm in length. Patients with dysplasia on succe...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(99)70380-9
更新日期:1999-05-01 00:00:00
abstract::Forceful dilation of the lower esophageal sphincter is considered primary therapy for achalasia. The Witzel pneumatic balloon dilator, unlike fluoroscopically placed dilators, is placed over a standard gastroscope allowing positioning and dilation under direct vision. We report our experience with the Witzel dilator i...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(90)71120-0
更新日期:1990-09-01 00:00:00
abstract:BACKGROUND:There is a significant interest in combination therapy using endoscopic epinephrine injection and thermal coagulation for nonvariceal hemostasis. The purpose of the study was to compare the relative effectiveness, ease of use, and safety of new Injection Gold Probes to other hemostasis techniques in three ra...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(98)70042-2
更新日期:1998-12-01 00:00:00
abstract:BACKGROUND AND AIMS:Stepwise radical endoscopic resection (SRER) has shown to be effective in eradicating Barrett's esophagus (BE) and its associated dysplasia. The aim of this study was to assess the long-term durability after successful SRER for early Barrett's neoplasia. METHODS:Patients treated with SRER for BE ≤5...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2017.04.018
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Ileoscopy is the criterion standard for mucosal lesions of terminal ileum but is performed in 5% of colonoscopy activity, and the need for training is undefined. OBJECTIVE:To assess the learning curve and skill-keeping line of ileoscopy. DESIGN:Prospective randomized study. SETTING:Single GI endoscopy uni...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.gie.2005.09.029
更新日期:2006-02-01 00:00:00
abstract:BACKGROUND:Endoscopic ultrasonographically guided fine-needle aspiration (EUS-FNA) is a safe and accurate method for obtaining diagnostic material from lesions within and immediately adjacent to the upper GI tract. OBJECTIVE:To determine whether EUS Trucut biopsy (EUS-TCB) (Quickcore, Wilson-Cook, Winstom Salem, NC) c...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2006.02.056
更新日期:2006-10-01 00:00:00
abstract::Mucosal pseudolipomatosis is a recently described colonoscopic finding, most likely caused by intramucosal air. We describe four asymptomatic patients with this lesion which completely resolved 3 weeks later on repeat colonoscopy. This is a benign, transient lesion with distinct endoscopic and histologic findings. The...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(89)72716-4
更新日期:1989-03-01 00:00:00
abstract:BACKGROUND:With recent advances in endoscopy, endoscopic techniques have surpassed esophagectomy in the treatment of dysplastic Barrett's esophagus (BE). OBJECTIVE:To compare the efficacy and safety of complete EMR and radiofrequency ablation (RFA) in the treatment of dysplastic BE. DESIGN:Systematic review of litera...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,评审
doi:10.1016/j.gie.2013.11.030
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:Anastomotic esophageal stenoses after esophageal resection are common and sometimes are refractory to Savary bougie dilation. The efficacy of electrocautery needle-knife treatment in these patients is described. METHODS:Twenty patients with a refractory anastomotic stricture of the esophagus were treated wi...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2005.06.016
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:Insertion of self-expandable metallic stents (SEMS) can provide rapid relief of malignant colorectal obstruction and can be used as a palliative treatment or as a bridge to surgery. A SEMS can be classified as an uncovered or covered stent. Both types of stents have their own merits and demerits. OBJECTIVE:...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章
doi:10.1016/j.gie.2007.02.064
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND:The duodenal-jejunal bypass liner (DJBL) is a new, device-based endoscopic treatment for type 2 diabetes mellitus (T2DM) and obesity. OBJECTIVE:To report serious safety events of subjects treated with the DJBL while offering a simple guideline to mitigate risk. DESIGN:Single-center observational study. SE...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2015.03.1911
更新日期:2015-11-01 00:00:00
abstract::We retrospectively reviewed 137 cases of outpatient endoscopic sphincterotomy (ES) performed over a 4-year period in a single center and compared them with an equal number of inpatient ES. The indications for ES in outpatients as compared with inpatients were, respectively: choledocholithiasis, 60% and 70%; papillary ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(89)72837-6
更新日期:1989-09-01 00:00:00
abstract::We evaluated the possibility that the addition of methylene blue to the sclerosant would improve the accuracy of intravariceal injections during endoscopic variceal sclerotherapy. Four patients had eight sessions of endoscopic variceal sclerotherapy with a sclerosant containing a combination of 3% sodium tetradecyl an...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(91)70676-7
更新日期:1991-03-01 00:00:00
abstract:BACKGROUND:Discrimination between neoplastic and non-neoplastic colorectal polyps is essential for determining appropriate treatment. The mucosal crypt pattern of polyps can be observed with a nonmagnifying colonoscope; however, mucosal crypt patterns are better seen by magnifying colonoscopy, which can also be a nonin...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1067/mge.2003.31
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:Direct peroral cholangioscopy (POC) by using an ultra-slim endoscope provides direct visualization of the bile duct and allows for therapeutic intervention. Holmium laser lithotripsy can be effective for retained bile duct stones, but it requires direct visualization during the procedure for safe and effecti...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2011.07.027
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND:The optimal endoscopic approach to the drainage of malignant hilar strictures remains controversial, especially with regard to the extent of desirable drainage and unilateral or bilateral stenting. OBJECTIVE:To identify useful criteria for predicting successful endoscopic drainage. DESIGN AND SETTING:Retro...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究
doi:10.1016/j.gie.2010.06.040
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:En bloc EMR is performed in Japan as a curative treatment for early stage gastric cancer. However, current methods of EMR are technically difficult and require proficiency in determining the extent of the cancer. This study assessed the feasibility of a new method to obviate these problems and to facilitate ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(04)01285-4
更新日期:2004-07-01 00:00:00
abstract:BACKGROUND:Covered, rather than uncovered, metal stents are used for the palliation of dysphagia from esophageal cancer, but a major drawback is the risk of stent migration, which occurs in up to 20% of patients. To overcome this problem, a double-layered stent, the Niti-S stent (Taewong Medical, Seoul, Korea), has bee...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2005.07.051
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:Despite recent advances in cytology brush design, yield of endoscopic brush cytology in suspected pancreatic carcinoma remains low. METHODS:We prospectively evaluated 32 such patients by ERCP to analyze differences in yield based on anatomic location of the pancreatic stricture, and the role of concurrent b...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(96)70168-2
更新日期:1996-09-01 00:00:00
abstract:BACKGROUND AND AIMS:An increasing number of patients are undergoing GI endoscopic procedures with active prescriptions for direct oral anticoagulants (DOACs). DOACs have been associated with a higher risk of GI bleeding (GIB) compared with warfarin. Our aims were to compare the risk of postendoscopic GIB and thromboemb...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2020.02.038
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND AND AIMS:Colonoscopy insertion is technically challenging, time-consuming, and painful, especially for the sigmoid. Several pilot studies indicated that the (left) tilt-down position could facilitate the insertion procedure, but no formal trials have been published to demonstrate its efficacy. We performed t...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.gie.2017.11.012
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:The cornerstone of management for acute cholecystitis is cholecystectomy. However, surgical intervention is contraindicated in the occasional patient. EUS-guided transduodenal gallbladder drainage may represent an effective minimally invasive alternative. OBJECTIVES:To describe a new technique, EUS-guided c...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2007.02.065
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:Obesity is becoming epidemic in proportion and is leading to considerable morbidity and mortality in the community. Bariatric surgery offers one tested solution to sustained weight loss and comorbidity reduction. However, it is associated with a significant number of complications. OBJECTIVE:The objective o...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,评审
doi:10.1016/j.gie.2009.06.025
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND AND AIMS:Removal of gastric button batteries (BBs) remains controversial. Our aim was to better define the spectrum of injury and to characterize clinical factors associated with injury from retained gastric BBs. METHODS:In this multicenter retrospective cohort study from January 2014 through May 2018, pedi...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2020.04.037
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:Endoscopic mucosal resection is an established treatment option for early stage gastric cancer. However, several problems with endoscopic mucosal resection remain to be solved, such as appropriate treatment for recurrence and incomplete tumor resection. The outcome for patients undergoing endoscopic aspirati...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2002.129085
更新日期:2002-11-01 00:00:00
abstract::There is a well-known discrepancy between East and West classifications of colorectal neoplasm, especially "intramucosal carcinoma," categorized as subgroup 4.4 in the Vienna classification, usually recognized as high-grade dysplasia in the United States and as carcinoma in situ in Japan. Focusing on management, in th...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,评审
doi:10.1016/j.gie.2019.12.021
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:A combination of midazolam and opioid is usually used to achieve sedation and analgesia during colonoscopy. Two commonly used opioids are meperidine and fentanyl, but few studies have compared their efficacy. OBJECTIVE:This randomized trial aimed to compare the efficacy and recovery time of 2 sedation regim...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.gie.2008.09.033
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:Wire-guided cannulation (WGC) was reported to decrease post-ERCP pancreatitis (PEP), but risk factors for PEP in WGC are not fully elucidated. OBJECTIVE:To evaluate the incidence and risk factors of PEP in WGC. DESIGN:Single-center retrospective study. SETTING:Academic center. PATIENTS:A total of 800 con...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2014.06.005
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Data on overtube-assisted enteroscopy to facilitate ERCP in patients with surgically altered pancreaticobiliary anatomy, or long-limb surgical bypass, is limited. OBJECTIVE:To evaluate and compare ERCP success by using single-balloon (SBE), double-balloon (DBE), or rotational overtube enteroscopy. DESIGN:C...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,多中心研究
doi:10.1016/j.gie.2012.10.015
更新日期:2013-04-01 00:00:00