Methods for Drainage of Distal Malignant Biliary Obstruction after ERCP Failure: A Systematic Review and Network Meta-Analysis
There is scarce evidence on the comparison between different methods for the drainage of distal malignant biliary obstruction (DMBO) after endoscopic retrograde cholangiopancreatography (ERCP) failure. Therefore, we performed a network meta-analysis to compare the outcomes of these techniques. We se...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-07-01
|
| Series: | Cancers |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6694/14/13/3291 |
| _version_ | 1797480546534686720 |
|---|---|
| author | Antonio Facciorusso Benedetto Mangiavillano Danilo Paduano Cecilia Binda Stefano Francesco Crinò Paraskevas Gkolfakis Daryl Ramai Alessandro Fugazza Ilaria Tarantino Andrea Lisotti Pietro Fusaroli Carlo Fabbri Andrea Anderloni |
| author_facet | Antonio Facciorusso Benedetto Mangiavillano Danilo Paduano Cecilia Binda Stefano Francesco Crinò Paraskevas Gkolfakis Daryl Ramai Alessandro Fugazza Ilaria Tarantino Andrea Lisotti Pietro Fusaroli Carlo Fabbri Andrea Anderloni |
| author_sort | Antonio Facciorusso |
| collection | DOAJ |
| description | There is scarce evidence on the comparison between different methods for the drainage of distal malignant biliary obstruction (DMBO) after endoscopic retrograde cholangiopancreatography (ERCP) failure. Therefore, we performed a network meta-analysis to compare the outcomes of these techniques. We searched main databases through September 2021 and identified five randomized controlled trials. The primary outcome was clinical success. The secondary outcomes were technical success, overall and serious adverse event rate. Percutaneous trans-hepatic biliary drainage was found to be inferior to other interventions (PTBD: RR 1.01, 0.88–1.17 with EUS-choledochoduodenostomy (EUS-CD); RR 1.03, 0.86–1.22 with EUS-hepaticogastrostomy (EUS-HG); RR 1.42, 0.90–2.24 with surgical hepaticojejunostomy). The comparison between EUS-HG and EUS-CD was not significant (RR 1.01, 0.87–1.17). Surgery was not superior to other interventions (RR 1.40, 0.91–2.13 with EUS-CD and RR 1.38, 0.88–2.16 with EUS-HG). No difference in any of the comparisons concerning adverse event rate was detected, although PTBD showed a slightly poorer performance on ranking analysis (SUCRA score 0.13). In conclusion, all interventions seem to be effective for the drainage of DMBO, although PTBD showed a trend towards higher rates of adverse events. |
| first_indexed | 2024-03-09T22:02:37Z |
| format | Article |
| id | doaj.art-750bfdb65d504a98bbaf7e225b044dc5 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T22:02:37Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-750bfdb65d504a98bbaf7e225b044dc52023-11-23T19:47:30ZengMDPI AGCancers2072-66942022-07-011413329110.3390/cancers14133291Methods for Drainage of Distal Malignant Biliary Obstruction after ERCP Failure: A Systematic Review and Network Meta-AnalysisAntonio Facciorusso0Benedetto Mangiavillano1Danilo Paduano2Cecilia Binda3Stefano Francesco Crinò4Paraskevas Gkolfakis5Daryl Ramai6Alessandro Fugazza7Ilaria Tarantino8Andrea Lisotti9Pietro Fusaroli10Carlo Fabbri11Andrea Anderloni12Gastroenterology Unit, Department of Surgical and Medical Sciences, University of Foggia, 71122 Foggia, ItalyGastrointestinal Endoscopy Unit, Humanitas Mater Domini, Via Gerenzano 2, 21053 Castellanza, ItalyGastrointestinal Endoscopy Unit, Humanitas Mater Domini, Via Gerenzano 2, 21053 Castellanza, ItalyGastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, AUSL Romagna, 47121 Forli, ItalyGastroenterology and Digestive Endoscopy Unit, Department of Medicine, The Pancreas Institute, University Hospital of Verona, 37100 Verona, ItalyDepartment of Gastroenterology, Hepatopancreatology, and Digestive Oncology, CUB Erasme Hospital, Université Libre de Bruxelles (ULB), 1050 Brussels, BelgiumGastroenterology and Hepatology, University of Utah Health, Salt Lake City, UT 801385, USADigestive Endoscopy Unit, Humanitas Clinical and Research Center-IRCCS, Via Manzoni 56, Rozzano, 20089 Milano, ItalyEndoscopy Service, Department of Diagnostic and Therapeutic Services, IRCCS-ISMETT, 90100 Palermo, ItalyGastroenterology Unit, Hospital of Imola, University of Bologna, 0039051 Bologna, ItalyGastroenterology Unit, Hospital of Imola, University of Bologna, 0039051 Bologna, ItalyGastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, AUSL Romagna, 47121 Forli, ItalyDigestive Endoscopy Unit, Humanitas Clinical and Research Center-IRCCS, Via Manzoni 56, Rozzano, 20089 Milano, ItalyThere is scarce evidence on the comparison between different methods for the drainage of distal malignant biliary obstruction (DMBO) after endoscopic retrograde cholangiopancreatography (ERCP) failure. Therefore, we performed a network meta-analysis to compare the outcomes of these techniques. We searched main databases through September 2021 and identified five randomized controlled trials. The primary outcome was clinical success. The secondary outcomes were technical success, overall and serious adverse event rate. Percutaneous trans-hepatic biliary drainage was found to be inferior to other interventions (PTBD: RR 1.01, 0.88–1.17 with EUS-choledochoduodenostomy (EUS-CD); RR 1.03, 0.86–1.22 with EUS-hepaticogastrostomy (EUS-HG); RR 1.42, 0.90–2.24 with surgical hepaticojejunostomy). The comparison between EUS-HG and EUS-CD was not significant (RR 1.01, 0.87–1.17). Surgery was not superior to other interventions (RR 1.40, 0.91–2.13 with EUS-CD and RR 1.38, 0.88–2.16 with EUS-HG). No difference in any of the comparisons concerning adverse event rate was detected, although PTBD showed a slightly poorer performance on ranking analysis (SUCRA score 0.13). In conclusion, all interventions seem to be effective for the drainage of DMBO, although PTBD showed a trend towards higher rates of adverse events.https://www.mdpi.com/2072-6694/14/13/3291EUSsurgerycancermetastasisstent |
| spellingShingle | Antonio Facciorusso Benedetto Mangiavillano Danilo Paduano Cecilia Binda Stefano Francesco Crinò Paraskevas Gkolfakis Daryl Ramai Alessandro Fugazza Ilaria Tarantino Andrea Lisotti Pietro Fusaroli Carlo Fabbri Andrea Anderloni Methods for Drainage of Distal Malignant Biliary Obstruction after ERCP Failure: A Systematic Review and Network Meta-Analysis Cancers EUS surgery cancer metastasis stent |
| title | Methods for Drainage of Distal Malignant Biliary Obstruction after ERCP Failure: A Systematic Review and Network Meta-Analysis |
| title_full | Methods for Drainage of Distal Malignant Biliary Obstruction after ERCP Failure: A Systematic Review and Network Meta-Analysis |
| title_fullStr | Methods for Drainage of Distal Malignant Biliary Obstruction after ERCP Failure: A Systematic Review and Network Meta-Analysis |
| title_full_unstemmed | Methods for Drainage of Distal Malignant Biliary Obstruction after ERCP Failure: A Systematic Review and Network Meta-Analysis |
| title_short | Methods for Drainage of Distal Malignant Biliary Obstruction after ERCP Failure: A Systematic Review and Network Meta-Analysis |
| title_sort | methods for drainage of distal malignant biliary obstruction after ercp failure a systematic review and network meta analysis |
| topic | EUS surgery cancer metastasis stent |
| url | https://www.mdpi.com/2072-6694/14/13/3291 |
| work_keys_str_mv | AT antoniofacciorusso methodsfordrainageofdistalmalignantbiliaryobstructionafterercpfailureasystematicreviewandnetworkmetaanalysis AT benedettomangiavillano methodsfordrainageofdistalmalignantbiliaryobstructionafterercpfailureasystematicreviewandnetworkmetaanalysis AT danilopaduano methodsfordrainageofdistalmalignantbiliaryobstructionafterercpfailureasystematicreviewandnetworkmetaanalysis AT ceciliabinda methodsfordrainageofdistalmalignantbiliaryobstructionafterercpfailureasystematicreviewandnetworkmetaanalysis AT stefanofrancescocrino methodsfordrainageofdistalmalignantbiliaryobstructionafterercpfailureasystematicreviewandnetworkmetaanalysis AT paraskevasgkolfakis methodsfordrainageofdistalmalignantbiliaryobstructionafterercpfailureasystematicreviewandnetworkmetaanalysis AT darylramai methodsfordrainageofdistalmalignantbiliaryobstructionafterercpfailureasystematicreviewandnetworkmetaanalysis AT alessandrofugazza methodsfordrainageofdistalmalignantbiliaryobstructionafterercpfailureasystematicreviewandnetworkmetaanalysis AT ilariatarantino methodsfordrainageofdistalmalignantbiliaryobstructionafterercpfailureasystematicreviewandnetworkmetaanalysis AT andrealisotti methodsfordrainageofdistalmalignantbiliaryobstructionafterercpfailureasystematicreviewandnetworkmetaanalysis AT pietrofusaroli methodsfordrainageofdistalmalignantbiliaryobstructionafterercpfailureasystematicreviewandnetworkmetaanalysis AT carlofabbri methodsfordrainageofdistalmalignantbiliaryobstructionafterercpfailureasystematicreviewandnetworkmetaanalysis AT andreaanderloni methodsfordrainageofdistalmalignantbiliaryobstructionafterercpfailureasystematicreviewandnetworkmetaanalysis |