{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T15:49:36Z","timestamp":1794412176858,"version":"4.9.0"},"reference-count":14,"publisher":"Georg Thieme Verlag KG","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:p>\n            Background\u2002We assessed efficacy and safety of endoscopic ultrasound-guided biliary drainage (EUS-BD) vs. endoscopic retrograde cholangiopancreatography (ERCP) as first-line intervention in malignant distal biliary obstruction (MDBO).<\/jats:p><jats:p>\n            Methods\u2002PubMed\/Medline, Embase, and Cochrane databases were searched until 01\u200a\/12\u200a\/2023 for randomized controlled trials of EUS-BD vs. ERCP for primary biliary drainage in patients with inoperable MDBO. The primary outcome was technical success. Secondary outcomes were clinical success, adverse events, mean procedure time, 1-year stent patency, and overall survival. Relative risk (RR) with 95\u200a%CI were calculated using a random effects model.<\/jats:p><jats:p>\n            Results\u2002Five studies (519 patients) were included. RR (95\u200a%CI) for EUS-BD was 1.06 (0.96 to 1.17; P\u200a=\u200a0.27) for pooled technical success and 1.02 (0.97 to 1.08; P\u200a=\u200a0.45) for clinical success. 1-year stent patency was similar between the groups (RR 1.15, 0.94 to 1.42; P\u200a=\u200a0.17), with lower reintervention with EUS-BD (RR 0.58, 0.37 to 0.9; P\u200a=\u200a0.01). The RR was 0.85 (0.49 to 1.46; P\u200a=\u200a0.55) for adverse events and 0.97 (0.10 to 0.17; P\u200a=\u200a0.98) for severe adverse events. On subgroup analysis, EUS-guided placement of lumen-apposing metal stent (LAMS) outperformed ERCP in terms of technical success (RR 1.17, 1.01 to 1.35; P\u200a=\u200a0.03). Procedure time was lower with EUS-BD (standardized mean difference \u20132.36 minutes [\u20132.68 to \u20132.05; P\u200a&lt;\u200a0.001]).<\/jats:p><jats:p>\n            Conclusions\u2002EUS-BD showed a statistically significant lower reintervention rate than ERCP, but with similar technical success, stent patency, clinical success, and safety. Technical success of EUS-BD with LAMS was better than ERCP.<\/jats:p>","DOI":"10.1055\/a-2340-0697","type":"journal-article","created":{"date-parts":[[2024,6,6]],"date-time":"2024-06-06T22:55:50Z","timestamp":1717714550000},"page":"955-963","source":"Crossref","is-referenced-by-count":59,"title":["Endoscopic ultrasound- versus ERCP-guided primary drainage of inoperable malignant distal biliary obstruction: systematic review and meta-analysis of randomized controlled trials"],"prefix":"10.1055","volume":"56","author":[{"given":"Tawfik","family":"Khoury","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Galilee Medical Center, Nahariya, Israel"},{"name":"Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel"},{"name":"Department of Gastroenterology, H\u00f4pital priv\u00e9 Jean Mermoz, Ramsay Sant\u00e9, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wisam","family":"Sbeit","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Galilee Medical Center, Nahariya, Israel"},{"name":"Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Lisotti","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, H\u00f4pital priv\u00e9 Jean Mermoz, Ramsay Sant\u00e9, Lyon, France"},{"name":"Gastroenterology Unit, Hospital of Imola, University of Bologna, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertrand","family":"Napol\u00e9on","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, H\u00f4pital priv\u00e9 Jean Mermoz, Ramsay Sant\u00e9, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabien","family":"Fumex","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, H\u00f4pital priv\u00e9 Jean Mermoz, Ramsay Sant\u00e9, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Marasco","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy"},{"name":"Division of Internal Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo H.","family":"Eusebi","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy"},{"name":"Gastroenterology Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Fusaroli","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy"},{"name":"Gastroenterology Unit, Hospital of Imola, University of Bologna, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon M.","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Shahin","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Galilee Medical Center, Nahariya, Israel"},{"name":"Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maamoun","family":"Basheer","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Galilee Medical Center, Nahariya, Israel"},{"name":"Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodica","family":"Gincul","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, H\u00f4pital priv\u00e9 Jean Mermoz, Ramsay Sant\u00e9, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Leblanc","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, H\u00f4pital priv\u00e9 Jean Mermoz, Ramsay Sant\u00e9, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony Y. B.","family":"Teoh","sequence":"additional","affiliation":[{"name":"Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00e9r\u00e9mie","family":"Jacques","sequence":"additional","affiliation":[{"name":"Service d'h\u00e9pato-gastroent\u00e9rologie, CHU Dupuytren Limoges, Limoges, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2024,8,9]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1055\/s-0043-109021","article-title":"Indications, results, and clinical impact of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline \u2013 Updated January 2017","volume":"49","author":"J M 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