Published online Sep 16, 2023. doi: 10.4253/wjge.v15.i9.574
Peer-review started: March 20, 2023
First decision: June 19, 2023
Revised: July 25, 2023
Accepted: August 23, 2023
Article in press: August 23, 2023
Published online: September 16, 2023
Adequately powered RCTS are need to confirm the findings in our retrospective study.
Transduodenal endoscopic ultrasound guided gallbladder drainage (EUS-GBD) appeard to be safer than transgastric drainage. Hot lumen apposing metallic stents (LAMS) is better than cold LAMS.
As per out study transduodenal approach appeared to have a more favorable adverse event (AE) profile with comparable technical and clinical success when compared to transgastric approach. Cautery enhanced LAMS has a more favorable AE and shorter procedure time than cold LAMS.
Literature search was done using PubMed, Embase, Scopus, CENTRAL, CINAHL, and Web of Science database. The inclusion criteria included randomized or nonrandomized controlled clinical trials and prospective and retrospective studies. Due to a lack of data, abstracts presented at conferences and case series (with four or more patients) were also included in the study. Reviews, meta-analyses, animal studies, letters from the editor, case reports, opinion articles, and editorials were not included. The other exclusion criteria included animal studies and studies in languages other than English. No age and gender restrictions were applied. A post-hoc analysis was done to compare the cautery-enhanced (hot) vs non-cautery enhanced approach and only twelve studies met the above-mentioned inclusion criteria. Manuscripts were reviewed for the data collection: Rate of AEs, clinical success, and technical success. The search was conducted again couple of days prior to the submission of this manuscript for the emerging data. Random effects models were estimated using Comprehensive Meta-Analysis (Biostat Inc.) software. A P value of less than 0.05 was considered significant.
Compare trans-gastric vs trans-enteric EUS-GBD based on available literature. Compare AE profile, technical success and clinical success of both approaches. As a secondary outcome compare cautery enhanced LAMS use vs non-cautery enhanced (cold) LAMS.
Identify if any transgastric or transenteric EUS-GBD is better based on existing literature.
EUS-GB being increasingly used either as bridge to cholecystectomy or as destination therapy. GB can be accessed by transgastric or transenteric route. However, it is unclear if one approach is better than the other.