METHODS: A comprehensive literature search of PubMed, Embase, Scopus, Web of Science, and the Cochrane Library was conducted for studies reporting the outcomes of EUS-CDS with LAMS. The main endpoints were the incidence of overall and specific AEs. Moreover, the stent dysfunction, and reintervention rates were evaluated independently.
RESULTS: A total of 21 studies (n = 1438) were included in the final meta-analysis. The pooled rate of technical and clinical success was 93.5% (95% confidence interval [CI]: 91.3-95.1) and 88.0% (95% CI: 83.9-91.1), respectively. After EUS-CDS with LAMS, the pooled incidence of overall AEs was 20.1% (95% CI: 16.0-24.9). The estimated rate of early AEs was 10.6% (95% CI: 7.9-14.2), and late AEs was 11.2% (95% CI: 8.2-15.2). Infection/cholangitis was the commonest AE, with a pooled incidence of 6.1% (95% CI: 3.7-10.1). The estimated incidence of stent dysfunction and reintervention was 10.5% (95% CI: 7.5-14.4), and 12.1% (95% CI: 9.3-15.7), respectively.
CONCLUSIONS: Despite with a high technical and clinical success rate, EUS-CDS with LAMS may be associated with overall AEs and stent dysfunction in one-fifth and one-tenth of cases, respectively. Further efforts are required to optimize its safety and long-term stent patency.
方法:对PubMed,Embase,Scopus,WebofScience,和Cochrane图书馆进行的研究报告EUS-CDS与LAMS的结果。主要终点是总体和特异性AE的发生率。此外,支架功能障碍,并独立评估再干预率.
结果:共有21项研究(n=1438)纳入最终的荟萃分析。技术和临床成功率分别为93.5%(95%置信区间[CI]:91.3-95.1)和88.0%(95%CI:83.9-91.1),分别。在使用LAMS的EUS-CDS之后,合并的整体AE发生率为20.1%(95%CI:16.0~24.9).早期AE的估计率为10.6%(95%CI:7.9-14.2),晚期不良事件发生率为11.2%(95%CI:8.2-15.2)。感染/胆管炎是最常见的AE,合并发生率为6.1%(95%CI:3.7-10.1)。支架功能障碍和再干预的估计发生率为10.5%(95%CI:7.5-14.4),和12.1%(95%CI:9.3-15.7),分别。
结论:尽管技术和临床成功率很高,在五分之一和十分之一的病例中,EUS-CDS与LAMS可能与整体AE和支架功能障碍相关,分别。需要进一步努力以优化其安全性和长期支架通畅性。