Chisthi MM. Unveiling the potential of electrocautery-enhanced lumen-apposing metal stents in endoscopic ultrasound-guided biliary drainage. World J Gastrointest Surg 2024; 16(7): 1956-1959 [PMID: 39087137 DOI: 10.4240/wjgs.v16.i7.1956]
Corresponding Author of This Article
Meer M Chisthi, MBBS, MS, Professor, Surgeon, Department of General Surgery, Government Medical College Pathanamthitta, Aanakuthi, Konni 689691, Kerala, India. meerchisthi@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
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World J Gastrointest Surg. Jul 27, 2024; 16(7): 1956-1959 Published online Jul 27, 2024. doi: 10.4240/wjgs.v16.i7.1956
Unveiling the potential of electrocautery-enhanced lumen-apposing metal stents in endoscopic ultrasound-guided biliary drainage
Meer M Chisthi
Meer M Chisthi, Department of General Surgery, Government Medical College Pathanamthitta, Konni 689691, Kerala, India
Author contributions: Chisthi MM was responsible for all work on the manuscript.
Conflict-of-interest statement: The author reports no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Meer M Chisthi, MBBS, MS, Professor, Surgeon, Department of General Surgery, Government Medical College Pathanamthitta, Aanakuthi, Konni 689691, Kerala, India. meerchisthi@gmail.com
Received: February 26, 2024 Revised: April 25, 2024 Accepted: May 13, 2024 Published online: July 27, 2024 Processing time: 146 Days and 22.8 Hours
Abstract
This editorial delves into Peng et al's article, published in the World Journal of Gastrointestinal Surgery. Peng et al's meta-analysis investigates the effectiveness of electrocautery-enhanced lumen-apposing metal stents (ECE-LAMS) in ultrasound-guided biliary drainage for alleviating malignant biliary obstruction. Examining 14 studies encompassing 620 participants, the research underscores a robust technical success rate of 96.7%, highlighting the efficacy of ECE-LAMS, particularly in challenging cases which have failed endoscopic retrograde cholangio pancreatography. A clinical success rate of 91.0% underscores its impact on symptom alleviation, while a reasonably tolerable adverse event rate of 17.5% is observed. However, the 7.3% re-intervention rate stresses the need for post-procedural monitoring. Subgroup analyses validate consistent outcomes, bolstering the applicability of ECE-LAMS. These findings advocate for the adoption of ECE-LAMS as an appropriate approach for biliary palliation, urging further exploration in real-world clinical contexts. They offer valuable insights for optimizing interventions targeting malignant biliary obstruction management.
Core Tip: This meta-analysis highlights the effectiveness of electrocautery-enhanced lumen-apposing metal stents (ECE-LAMS) in ultrasound-guided biliary drainage for malignant obstruction. Based on diverse studies, it demonstrates a strong technical success rate of 96.7%, showcasing ECE-LAMS' efficacy in challenging cases post-failed endoscopic retrograde cholangio pancreatography. The notably high clinical success rate underscores its impact on symptom relief, and the safety profile is deemed acceptable. However, the observed adverse events and re-intervention rate emphasize the importance of vigilant post-procedural monitoring. Consistent outcomes across subgroups enhance the applicability of ECE-LAMS, positioning it as a versatile tool for palliation in cases of malignant biliary obstruction.
