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percutaneous transhepatic cholangiography vs endoscopic ultrasound-guided biliary drainage:A systematic review

World Journal of Gastroenterology 2022年第27期28卷 3514-3523页

作者： Zeinab Hassan Eyad Gadour Internal Medicine Stockport Hospitals NHS Foundation TrustManchester SK27JEUnited Kingdom Department of Gastroenterology University Hospitals of Morecambe Bay NHS Foundation TrustLancaster LA14RPUnited Kingdom

BACKGROUND percutaneous transhepatic cholangiography is a diagnostic and therapeutic procedure that involves inserting a needle into the biliary tree,followed by the immediate insertion of a *** ultrasound-guided biliary drainage(EUS-BD)is a novel technique that allows BD by echoendoscopy and fluoroscopy using a stent from the biliary tree to the gastrointestinal *** To compare the technical aspects and outcomes of percutaneous transhepatic BD(PTBD)and *** Different databases,including PubMed,Embase,***,the Cochrane library,Scopus,and Google Scholar,were searched according to the guidelines for Preferred Reporting Items for Systematic reviews and Meta-Analyses to obtain studies comparing PTBD and *** Among the six studies that fulfilled the inclusion criteria,PTBD patients underwent significantly more reinterventions(4.9 vs 1.3),experienced more postprocedural pain(4.1 vs 1.9),and experienced more late adverse events(53.8%vs 6.6%)than EUS-BD *** was a significant reduction in the total bilirubin levels in both the groups(16.4-3.3μmol/L and 17.2-3.8μmol/L for EUSBD and PTBD,respectively;P=0.002)at the 7-d *** were no significant differences observed in the complication rates between PTBD and EUSBD(3.3 vs 3.8).PTBD was associated with a higher adverse event rate than EUSBD in all the procedures,including reinterventions(80.4%vs 15.7%,respectively)and a higher index procedure(39.2%vs 18.2%,respectively).CONCLUSION The findings of this systematic review revealed that EUS-BD is linked with a higher rate of effective BD and a more manageable procedure-related adverse event profile than *** findings highlight the evidence for successful EUS-BD implementation.

关键词： percutaneous transhepatic cholangiography Endoscopic ultrasound Biliary drainage Obstructive cholangiopathy

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