Abstract:
:EUS-guided biliary drainage (EUS-BD) has been used as a salvage modality for relief of malignant biliary obstruction (MBO) after a failed ERCP. Multiple recent randomized controlled trials (RCTs) and observational studies have been published to assess the suitability of EUS-BD as a first-line modality for achieving palliative BD. We aimed to perform a systematic review and meta-analysis comparing primary EUS-BD versus ERCP for MBO. We searched PubMed, Medline, and Embase up to January 1, 2019, to identify RCTs and observational studies evaluating the efficacy and safety of primary EUS-BD (without a prior attempted ERCP) versus ERCP. Quality of RCTs and observational studies was assessed using Jadad and Newcastle-Ottawa scores, respectively. The outcomes of interest were technical success, clinical success, odds of requiring a repeat intervention, and procedure-related adverse events. Odds ratios (ORs) and standard mean difference were calculated for categorical and continuous variables, respectively. Meta-analysis was performed using the random effects model in RevMan 5.3 (the Cochrane Collaboration, the Nordic Cochrane Centre, Copenhagen, Denmark). Five studies (three RCTs and two observational studies) with 361 patients were included. Both procedures achieved comparable technical success (OR: 1.20 [0.44-3.24], I2 = 0%) and clinical success (OR: 1.44, confidence interval [CI]: 0.63-3.29, I2 = 0%). The overall adverse outcomes (OR: 1.59 [0.89-2.84]) did not differ between the two groups. In the ERCP group, 9.5% of patients developed procedure-related pancreatitis versus zero in the EUS group (risk difference = 0.08%, P = 0.02). There was no statistically significant difference in nonpancreatitis-related adverse events. The odds of requiring reintervention for BD (1.68 [0.76-3.73], I2 = 42%) did not differ significantly. The ERCP group had significantly higher odds of requiring reintervention due to tumor overgrowth (5.35 [1.64-17.50], I2 = 0%). EUS-BD has comparable technical and clinical success to ERCP and can potentially be used as a first-line palliative modality for MBO where expertise is available. ERCP-related pancreatitis which can cause significant morbidity can be completely avoided with EUS.
journal_name
Endosc Ultrasoundjournal_title
Endoscopic ultrasoundauthors
Kakked G,Salameh H,Cheesman AR,Kumta NA,Nagula S,DiMaio CJdoi
10.4103/eus.eus_10_20subject
Has Abstractpub_date
2020-09-01 00:00:00pages
298-307issue
5eissn
2303-9027issn
2226-7190pii
289380journal_volume
9pub_type
杂志文章,评审abstract::Hepaticogastrostomy (HGS) has been reported for the management of palliative malignant hilar stricture and involves draining the left liver as rescue therapy. For the management of this complex stenosis, another new option for draining the right liver under EUS guidance was introduced. Ten publications involving 38 pa...
journal_title:Endoscopic ultrasound
pub_type: 杂志文章,评审
doi:10.4103/eus.eus_52_19
更新日期:2019-11-28 00:00:00
abstract::Submucosal tumors (SMTs) are usually discovered fortuitously during routine endoscopy, including various non-neoplastic and neoplastic conditions. Endoscopic ultrasound (EUS) is considered to be the best imaging procedure to characterize SMTs and to determine the need for further treatment. In this review, the followi...
journal_title:Endoscopic ultrasound
pub_type: 杂志文章,评审
doi:10.7178/eus.06.003
更新日期:2013-07-01 00:00:00
abstract:INTRODUCTION:Hemosuccus pancreaticus (HP), hemorrhage from the papilla of Vater through the pancreatic duct (PD), is a rare cause of upper gastrointestinal bleeding. It may be caused by chronic pancreatitis, pseudoaneurism and pancreatic tumors. Only 2% of HP involves the hepatic arteries. Endoscopic ultrasound (EUS) m...
journal_title:Endoscopic ultrasound
pub_type: 杂志文章
doi:
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:Laparoscopic and natural orifice transluminal endoscopic surgery techniques can diagnose peritoneal findings that suggest tumor cell dissemination. However, they have not been incorporated into routine practice, mainly owing to their complexity. To develop a minimally invasive endoscopic technique for the di...
journal_title:Endoscopic ultrasound
pub_type: 杂志文章
doi:10.4103/2303-9027.144535
更新日期:2014-10-01 00:00:00
abstract:Background and Objective:EUS-FNA sensitivity for malignancy in parenchymal masses of patients with concurrent chronic pancreatitis (CP) has been reported to be unsatisfactory. The aim of the present study was to directly compare the diagnostic accuracy of EUS-FNA and EUS-fine-needle biopsy (FNB) in differentiating betw...
journal_title:Endoscopic ultrasound
pub_type: 杂志文章
doi:10.4103/eus.eus_75_19
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Extra-pancreatic cysts (EPCs) are incidentally found in patients with pancreatic cystic lesions (PCLs). The aim of this study is to find the prevalence of concurrent EPC in patients with PCLs, investigate associations with neoplastic lesions, and compare the prevalence of EPC to a control popu...
journal_title:Endoscopic ultrasound
pub_type: 杂志文章
doi:10.4103/2303-9027.163001
更新日期:2015-07-01 00:00:00
abstract::Pancreatic adenocarcinoma may account for more than 80% of all pancreatic neoplasms. Occasionally, other rare tumors such as lymphoma, metastatic tumor, and solid pseudopapillary neoplasm can be considered in the differential diagnosis. We report the case of an 82-year-old man with a pancreatic solid mass. This case s...
journal_title:Endoscopic ultrasound
pub_type:
doi:10.4103/2303-9027.190923
更新日期:2017-07-01 00:00:00
abstract:Background and Objectives:There is an increasing global interest in screening programs aiming to detect pancreatic cancer (PC) in an early and potentially curable stage. Concerns still remain as to whether screening would confer any survival benefit. Another approach to evaluate the benefits of the pancreatic screening...
journal_title:Endoscopic ultrasound
pub_type: 杂志文章,评审
doi:10.4103/eus.eus_25_18
更新日期:2019-01-01 00:00:00
abstract:INTRODUCTION:The number of endoscopic ultrasonography (EUS) for esophageal subepithelial lesion (SEL) is on the increase recently. We retrospectively investigated the 230 patients who underwent EUS for esophageal SEL from July 2010 to June 2013. We analyzed EUS finding and assumptive diagnosis. RESULTS:Among 230 enrol...
journal_title:Endoscopic ultrasound
pub_type: 杂志文章
doi:
更新日期:2014-04-01 00:00:00
abstract::Endoscopic submucosal dissection (ESD) is an innovative advance in the treatment of early gastrointestinal (GI) cancer without lymph node metastases and precancerous lesions as it is an effective and safe therapeutic method. ESD has also been a promising therapeutic option for removal of submucosal tumors (SMTs) for i...
journal_title:Endoscopic ultrasound
pub_type: 杂志文章,评审
doi:10.4103/2303-9027.191606
更新日期:2016-09-01 00:00:00
abstract::Pancreatic metastases are rare, ranging from 2% to 5% of pancreatic malignancies. Differentiating a primary pancreatic malignancy from a metastasis can be difficult due to similarities on imaging findings, but is crucial to ensure proper treatment. Although transabdominal ultrasound, computed tomography, and magnetic ...
journal_title:Endoscopic ultrasound
pub_type:
doi:10.4103/2303-9027.156746
更新日期:2015-04-01 00:00:00
abstract::Endoscopic ultrasound (EUS) is one of the best diagnostic methods for diseases of the digestive tract and surrounding organs. Whereas EUS-guided fine needle aspiration (FNA) has been very useful for providing histological confirmation for previously hard to reach lesions, elastography is aiming to obtain a "virtual bi...
journal_title:Endoscopic ultrasound
pub_type: 杂志文章,评审
doi:10.4103/2303-9027.123009
更新日期:2014-04-01 00:00:00
abstract::Metastatic cancer to the pancreas is rare and accounts for less than 2% of all pancreatic malignancies. Renal cell cancer, malignant melanoma, lung, colon and breast carcinoma are among the few tumors known to metastasize to the pancreas. The pancreas is a rare site of solitary metastasis, but it is often involved in ...
journal_title:Endoscopic ultrasound
pub_type:
doi:10.4103/2303-9027.121248
更新日期:2013-10-01 00:00:00
abstract:Background and Objectives:EUS-guided biliary drainage (EUS-BD) has emerged as a complementary technique for primary drainage or as a rescue technique after failed endoscopic retrograde cholangiography. The objective of this study was to demonstrate the feasibility of EUS-BD for malignant hilar stenosis (MHS), both as a...
journal_title:Endoscopic ultrasound
pub_type: 杂志文章
doi:10.4103/eus.eus_68_20
更新日期:2021-01-05 00:00:00
abstract:Background and Objectives:EUS guided core biopsy was once rarely performed but is now entering mainstream practice. Neuroendocrine tumors often warrant core biopsy as sufficient tissue must be obtained to allow for special staining to ensure a correct diagnosis. Traditionally these lesions were sampled with FNA needles...
journal_title:Endoscopic ultrasound
pub_type: 杂志文章
doi:10.4103/eus.eus_51_17
更新日期:2018-09-01 00:00:00
abstract:Objectives:The project is aimed to compare the tissue sampling rate and the diagnostic accuracy rate of EUS-FNA using 22G nitinol and reverse bevel-tipped needles. Subjects and Methods:This was a prospective, randomized, crossover study in a tertiary academic hospital. All consecutive adult patients undergoing EUS-gui...
journal_title:Endoscopic ultrasound
pub_type: 杂志文章
doi:10.4103/eus.eus_113_17
更新日期:2018-01-01 00:00:00
abstract:Backgrounds and Objectives:No study on the use of lumen-apposing fully covered self-expanding metal stent (LAMS) to drain pancreatic fluid collections (PFCs) has evaluated outcomes of patients in the outpatient setting. The objective of this multicenter study was to evaluate the clinical outcomes, success rate, and adv...
journal_title:Endoscopic ultrasound
pub_type: 杂志文章
doi:10.4103/eus.eus_30_17
更新日期:2019-01-01 00:00:00
abstract:Background and Objective:Robust data in favor of clear superiority of 22G fine-needle biopsy (FNB) over 22G FNA for an echoendoscopic-guided sampling of pancreatic masses are lacking. The objective of this study is to compare the diagnostic outcomes and sample adequacy of these two needles. Materials and Methods:Compu...
journal_title:Endoscopic ultrasound
pub_type: 杂志文章,评审
doi:10.4103/eus.eus_4_19
更新日期:2020-05-01 00:00:00
abstract::Basic technique for endoscopic ultrasound (EUS) of solid lesions has developed during 30 years of EUS, as endoscopes and accessory equipment, particularly needles, have been developed. Systematic high-quality examinations require understanding and planning. Needles used for EUS-guided fine needle aspiration (FNA) have...
journal_title:Endoscopic ultrasound
pub_type: 杂志文章,评审
doi:10.4103/2303-9027.124313
更新日期:2014-01-01 00:00:00
abstract::Pancreatic lymphangiomas are rare, but benign neoplasms. Historically, the diagnoses in various case reports were mostly made after surgical resection. There are emerging data concerning the utility of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) to differentiate it from more sinister pancreatic cysti...
journal_title:Endoscopic ultrasound
pub_type:
doi:10.4103/2303-9027.204807
更新日期:2017-03-01 00:00:00
abstract::Lung cancer is one of the major causes of death in the world. Small cell carcinoma is the most aggressive type and can spread rapidly. The association of a small cell carcinoma with hepatic hilar metastasis and biliary obstruction is rare. Endoscopic ultrasound allows the aspiration of a cytology sample from adenopath...
journal_title:Endoscopic ultrasound
pub_type:
doi:10.4103/2303-9027.193570
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVE:The published data on the accuracy of the detection of pancreas divisum by endoscopic ultrasound (EUS) is limited. In this study, we evaluate the accuracy of detection of pancreas divisum by radial EUS in patients with chronic pancreatitis. METHODS:We retrospectively evaluated patients with chronic pancreati...
journal_title:Endoscopic ultrasound
pub_type: 杂志文章
doi:10.7178/eus.04.003
更新日期:2013-01-01 00:00:00
abstract::This systematic review aims to assess the literature to determine the impact of EUS for diagnosing malignancy among indeterminate extrahepatic biliary strictures. A systematic review was performed using MEDLINE, EMBASE, Cochrane, and conference proceedings from inception to July 2016. Pooled results were calculated us...
journal_title:Endoscopic ultrasound
pub_type: 杂志文章,评审
doi:10.4103/eus.eus_24_19
更新日期:2019-09-01 00:00:00
abstract::Direct referral of patients for EUS - instead of preprocedural consultation with the endosonographer - has become standard practice (like for other endoscopic procedures) as it is time- and cost-effective. To ensure appropriate indications and safe examinations, the endosonographer should carefully consider what infor...
journal_title:Endoscopic ultrasound
pub_type: 杂志文章,评审
doi:10.4103/eus.eus_54_18
更新日期:2019-01-01 00:00:00
abstract:Background and Objectives:EUS-guided tissue acquisition with rapid on-site cytologic evaluation (ROSE) has been used to increase the diagnostic yield. However, ROSE is not available in many centers. To date, only a few studies have assessed the adequacy of histologic cores in macroscopic on-site evaluation (MOSE) durin...
journal_title:Endoscopic ultrasound
pub_type: 杂志文章
doi:10.4103/eus.eus_34_19
更新日期:2019-09-01 00:00:00
abstract:OBJECTIVE:Angiogenesis is a crucial event for pancreatic carcinogenesis, and it also plays an important role in chronic pancreatitis. The aim of our study was to evaluate the mRNA expression of vascular endothelial growth factor (VEGF) and epidermal growth factor receptor (EGFR) in chronic inflammatory or malignant pan...
journal_title:Endoscopic ultrasound
pub_type: 杂志文章
doi:10.4103/2303-9027.117692
更新日期:2013-04-01 00:00:00
abstract::Double layered peritoneal folds or ligaments act as conduits for the passage of blood vessels in intraperitoneal organs and also provide a pathway for the spread of disease. It is difficult to identify these normal peritoneal folds at imaging. Computed tomography is the most common imaging modality used to detect dise...
journal_title:Endoscopic ultrasound
pub_type: 杂志文章
doi:10.4103/2303-9027.151317
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the diagnostic value of endoscopic ultrasonography (EUS) and contrast-enhanced harmonic (CEH) EUS in patients with gastrointestinal stromal tumors (GISTs). PATIENTS AND METHODS:About 19 patients with suspected GISTs underwent EUS and CEH-EUS before tumor resection. The malignant potential was ass...
journal_title:Endoscopic ultrasound
pub_type: 杂志文章
doi:10.4103/2303-9027.180475
更新日期:2016-03-01 00:00:00
abstract:Background and Objectives:EUS-FNA is applied widely in clinical practice, but there remains a lack of authentic training models. The present study aimed to develop a novel swine training model and to perform a preliminary assessment of its feasibility and efficacy. Materials and Methods:To create an internal lesion-li...
journal_title:Endoscopic ultrasound
pub_type: 杂志文章
doi:10.4103/eus.eus_13_20
更新日期:2020-07-01 00:00:00
abstract::Numerous clinical pathways exist for patients presenting with a suspicious pancreatic mass. These range from direct surgical intervention following staging, with preoperative cross-sectional imaging, EUS with or without fine-needle aspiration or fine-needle core biopsy; neoadjuvant chemotherapy and/or radiation therap...
journal_title:Endoscopic ultrasound
pub_type: 杂志文章
doi:10.4103/eus.eus_28_20
更新日期:2020-05-01 00:00:00