手术解剖结构改变患者的内镜超声引导下胆道引流：一项系统评价和Meta分析

Endoscopic ultrasound‑guided biliary drainage in patients with surgically altered anatomy: a systematic review and Meta‑analysis.

作者信息

Tanisaka Yuki, Mizuide Masafumi, Fujita Akashi, Jinushi Ryuhei, Shiomi Rie, Shin Takahiro, Hirata Dai, Terada Rie, Tashima Tomoaki, Mashimo Yumi, Ryozawa Shomei

机构信息

Department of Gastroenterology, Saitama Medical University International Medical Center, Saitama, Japan.

出版信息

Scand J Gastroenterol. 2023 Feb;58(2):107-115. doi: 10.1080/00365521.2022.2111228. Epub 2022 Aug 20.

DOI:10.1080/00365521.2022.2111228

PMID:35993426

Abstract

BACKGROUND AND AIMS

Endoscopic retrograde cholangiopancreatography is technically challenging to perform in patients with surgically altered anatomy (SAA). For these patients, endoscopic ultrasound-guided biliary drainage (EUS-BD) is one of the good indications. The aim of our systematic review and meta-analysis was to identify and evaluate evidence of the efficacy and safety of EUS-BD in patients with SAA.

METHODS

A systematic review of the PubMed was conducted through to December 2021 to identify studies performing EUS-BD in patients with SAA. The primary outcome was the pooled technical success proportion in patients with SAA. The pooled clinical success and adverse event proportions in patients with SAA were also analyzed.

RESULTS

The search identified 1195 possible records, with 18 studies meeting our criteria for analysis, reporting data for 409 patients with SAA who underwent EUS-BD. The pooled technical success, clinical success and adverse event proportions in patients with SAA were 97.8% (95% confidence interval [CI], 95.8-99.7%), 94.9% (95% CI, 91.8-98.1%), and 12.8% (95% CI, 7.4-18.1%), respectively.

CONCLUSIONS

EUS-BD is effective for patients with SAA. However, adverse events should be considered when performing EUS-BD in these patients.

摘要

背景与目的

对于手术改变解剖结构（SAA）的患者，内镜逆行胰胆管造影术在技术上具有挑战性。对于这些患者，内镜超声引导下胆道引流术（EUS-BD）是较好的适应证之一。我们进行系统评价和荟萃分析的目的是识别和评估EUS-BD在SAA患者中的有效性和安全性证据。

方法

对PubMed进行系统检索至2021年12月，以识别在SAA患者中进行EUS-BD的研究。主要结局是SAA患者的汇总技术成功率。还分析了SAA患者的汇总临床成功率和不良事件发生率。

结果

检索到1195条可能的记录，18项研究符合我们的分析标准，报告了409例接受EUS-BD的SAA患者的数据。SAA患者的汇总技术成功率、临床成功率和不良事件发生率分别为97.8%（95%置信区间[CI]，95.8 - 99.7%）、94.9%（95%CI，91.8 - 98.1%）和12.8%（95%CI，7.4 - 18.1%）。