在远端恶性胆道阻塞中对4种一线内镜胆道排水方式进行比较:系统性审查和网络元分析
Gunn Huh1, Won-Mook Choi1, Jung Bok Lee2
1Division of Gastroenterology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Endoscopic ultrasound
|January 26, 2026
概括
以内镜超声波 (EUS) 引导的胆管排水为远端恶性胆管阻塞提供了与ERCP相比的临床成功. EUS-CDS-LAMS显示出更高的技术成功率,而EUS-HGS则有更少的再干预和更好的支架穿透性.
科学领域:
- 胃肠病学 胃肠病学
- 干预性内镜检查是干预性的内镜检查.
- 在瘤学瘤学.
背景情况:
- 远端恶性胆道阻塞 (DMBO) 在患者管理中带来了重大挑战.
- 内镜逆行胆血管细胞造影 (ERCP) 是一种标准的治疗方法,但EUS指导胆道排水正在成为一个可行的替代方案.
- 不同初级内镜排水技术对DMBO的比较疗效需要进一步研究.
研究的目的:
- 为了比较四种主要内镜胆汁排水方式的临床结果:ERCP,EUS-肝胃肠肠肠肠 (HGS),EUS-胆固醇双肠肠肠肠肠肠肠 (CDS) 带有光线附加金属支架 (LAMS),以及EUS-CDS带有自扩展金属支架 (SEMS).
- 评估技术成功,手术时间,不良事件,再干预率和每种模式的支架穿透性.
主要方法:
- 进行了系统的文献搜索,直到2024年7月.
- 一个网络元分析包括5项随机对照试验和3项比较研究,共计796名患者.
- 评估结果包括临床成功,技术成功,手术时间,不良事件,再干预率和支架通透性.
主要成果:
- 在所有四种方法中,临床成功率和不良事件率都是可比的.
- 与ERCP和EUS-CDS-SEMS相比,EUS-CDS-LAMS表现出明显更高的技术成功率和更短的程序时间.
- 与ERCP相比,EUS-HGS显示了减少再干预和在6个月后更高的支架穿透率的趋势.
结论:
- 由EUS指导的胆汁排水技术,特别是EUS-CDS-LAMS和EUS-HGS,为DMBO提供了ERCP的有希望的替代方案.
- 在技术成功和程序持续时间方面,EUS-CDS-LAMS提供了优势.
- EUS-HGS可能会在长期的支架穿透性和减少重新干预率方面带来好处,这值得在临床实践中考虑.
相关概念视频
Protein Networks
4.5K
An organism can have thousands of different proteins, and these proteins must cooperate to ensure the health of an organism. Proteins bind to other proteins and form complexes to carry out their functions. Many proteins interact with multiple other proteins creating a complex network of protein interactions.
These interactions can be represented through maps depicting protein-protein interaction networks, represented as nodes and edges. Nodes are circles that are representative of a protein,...
These interactions can be represented through maps depicting protein-protein interaction networks, represented as nodes and edges. Nodes are circles that are representative of a protein,...
4.5K
Review and Preview
8.4K
In statistics, several tools are used to interpret the data. Measures of central tendency represent the characteristics of the data, such as mean, median, and mode. Additionally, measures of variance like standard deviation and range are used to find the spread of data from the mean. Relative standing measures the distance between data locations. Commonly used measures of relative standings are percentile, z score, and quartiles.
Percentiles are a type of fractile that partition data into...
Percentiles are a type of fractile that partition data into...
8.4K
Review and Preview
11.1K
Data are individual items of information obtained from a population or sample. Data may be classified as qualitative (categorical), quantitative continuous, or quantitative discrete. Because it is not practical to measure the entire population in a study, researchers use samples to represent the population. A random sample is a representative group from the population chosen by using a method that gives each individual in the population an equal chance of being included in the sample. Random...
11.1K
Sensory Modalities
3.9K
Sensation typically is the process by which the sensory receptors and sense organs detect stimuli from the internal and external environment and transmit this information to the central nervous system for processing.
General senses refer to the broad category of sensory information detected by receptors in the body and can be further grouped into somatic and visceral senses. Somatic sensations include touch, pressure, temperature, and pain and are essential for navigating our environment and...
General senses refer to the broad category of sensory information detected by receptors in the body and can be further grouped into somatic and visceral senses. Somatic sensations include touch, pressure, temperature, and pain and are essential for navigating our environment and...
3.9K
Directing Effect of Substituents: meta-Directing Groups
5.9K
Substituents on the benzene ring that direct an incoming electrophile to undergo substitution at the meta position are called meta directors. All meta directors either have a positive charge on the atom directly bonded to the ring or a partial positive charge. These groups function by withdrawing electrons from the ring through inductive and resonance effects. Consider the carbocation intermediates formed upon the addition of an electrophile on nitrobenzene at the...
5.9K
Random and Systematic Errors
14.8K
Scientists always try their best to record measurements with the utmost accuracy and precision. However, sometimes errors do occur. These errors can be random or systematic. Random errors are observed due to the inconsistency or fluctuation in the measurement process, or variations in the quantity itself that is being measured. Such errors fluctuate from being greater than or less than the true value in repeated measurements. Consider a scientist measuring the length of an earthworm using a...
14.8K


