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. 2017 Apr 3:10:67-74.
doi: 10.2147/CEG.S132004. eCollection 2017.

Endoscopic ultrasound-guided biliary drainage versus percutaneous transhepatic biliary drainage after failed endoscopic retrograde cholangiopancreatography: a meta-analysis

Ramkaji Baniya  1 , Sunil Upadhaya  1 , Seetharamprasad Madala  1 , Subash Chandra Subedi  1 , Tabrez Shaik Mohammed  1 , Ghassan Bachuwa  1
Affiliations

Endoscopic ultrasound-guided biliary drainage versus percutaneous transhepatic biliary drainage after failed endoscopic retrograde cholangiopancreatography: a meta-analysis

Ramkaji Baniya et al. Clin Exp Gastroenterol. .

Abstract

The failure rate of endoscopic retrograde cholangiopancreatography for biliary cannulation is approximately 6%-7% in cases of obstructive jaundice. Percutaneous transhepatic biliary drainage (PTBD) is the procedure of choice in such cases. Endoscopic ultrasound-guided biliary drainage (EGBD) is a novel technique that allows biliary drainage by echoendoscopy and fluoroscopy using a stent from the biliary tree to the gastrointestinal tract. Information in PubMed, Scopus, clinicaltrials.gov and Cochrane review were analyzed to obtain studies comparing EGBD and PTBD. Six studies fulfilled the inclusion criteria. Technical (odds ratio (OR): 0.34; confidence interval (CI) 0.10-1.14; p=0.05) and clinical (OR: 1.48; CI 0.46-4.79; p=0.51) success rates were not statistically significant between the EGBD and PTBD groups. Mild adverse events were nonsignificantly different (OR: 0.36; CI 0.10-1.24; p=0.11) but not the moderate-to-severe adverse events (OR: 0.16; CI 0.08-0.32; p≤0.00001) and total adverse events (OR: 0.34; CI 0.20-0.59; p≤0.0001). EGBD is equally effective but safer than PTBD.

Keywords: clinical success; endoscopic ultrasound-guided biliary drainage; failed endoscopic retrograde cholangiopancreatography; percutaneous transhepatic biliary drainage; technical success.

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Conflict of interest statement

Disclosure The authors report that no conflicts of interest in this work.

Figures

Figure 1
Figure 1
PRISMA statement of the study. Abbreviations: PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analysis; ERCP, endoscopic retrograde cholangiopancreatographic.
Figure 2
Figure 2
(A) Forest plot of technical success and (B) forest plot of clinical success. Abbreviations: EGBD, endoscopic ultrasound-guided biliary drainage; PTBD, percutaneous transhepatic biliary drainage; M–H, Mantel–Haenszel test.
Figure 3
Figure 3
Forest plots of mild, moderate to severe, and total adverse events. Notes: (A) Forest plot of mild adverse events; (B) forest plot of moderate to severe adverse events; (C) forest plot of total adverse events. Abbreviations: EGBD, endoscopic ultrasound-guided biliary drainage; PTBD, percutaneous transhepatic biliary drainage; M–H, Mantel–Haenszel test.
See this image and copyright information in PMC

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