Endoscopic-ultrasound-guided biliary drainage with placement of electrocautery-enhanced lumen-apposing metal stent for palliation of malignant biliary obstruction: Updated meta-analysis

Table 1 Characteristics of studies included in the meta-analysis

Ref.	Country	Setting, center involved (n)	Patient (n)	Age (yr)	Etiology (n)	Reason for failed ERCP (n)	Stent diameter (n)	Follow-up (d)
Tsuchiya et al[33], 2018	Japan, China	Prospective, multicenter (5)	19	mean 70.6 (SD, 13.9)	Pancreatic cancer (10), cholangiocarcinoma (2), metastatic renal cancer (2), ampullary cancer (1), metastatic colon cancer (1), sarcoma (1), duodenal cancer (1), metastatic gastric cancer (1)	Duodenal stenosis (4), cannulation failure (15)	6 mm (10), 8 mm (9)	mean 205.0 (SD, 187.9)
Anderloni et al[30], 2019	Italy	Retrospective, single-center	46	mean 73.1 (SD, 12.6)	Pancreatic cancer (40), duodenal cancer (3), ampullary cancer (2), cholangiocarcinoma (1)	Tumoral involvement of the papilla (19), duodenal stenosis (9), cannulation failure (12), ampulla obscured by prior stents (6)	6 mm (21), 8 mm (19), 10 mm (6)	mean 114.4 (95%CI: 73.2-155.4)
El Chafic et al[25], 20191	United States	Retrospective, multicenter (6)	67	mean 68.8 (SD, 11.8)	Peri-ampullary cancer (56), metastatic cancer (11)	Duodenal stenosis (29), tumoral involvement of the papilla (29), cannulation failure (9)	10 mm (67)	median 119.0 (range, 28-567)
Jacques et al[28], 2019	France	Retrospective, multicenter (10)	52	mean 78 (range, 61-92)	Pancreatic cancer (43), cholangiocarcinoma (2), degenerated IPMN (2), duodenal lymphoma (1), peritoneal carcinomatosis (1), stones (1), duodenal cancer (2)	Tumoral involvement of the papilla (10), duodenal stenosis (18), cannulation failure (14), ampulla obscured by prior stents (9), other (1)	6 mm (43), 8 mm (7), 10 mm (2)	mean 157
Chin et al[26], 20202	New Zealand	Retrospective, single-center	60	median 76 (range, 52-90)	Pancreatic cancer (47), cholangiocarcinoma (3), metastatic cancer (6), duodenal cancer (2), lymphoma (2)	All patients underwent biliary drainage after ERCP failed, but details were not reported	8 mm (43), 10 mm (17)	mean 237
Jacques et al[31], 2020	France	Retrospective, multicenter (8)	70	mean 75 (range, 61-92)	Pancreatic cancer (54), cholangiocarcinoma (3), ampullary cancer (4), duodenal cancer (2), other (7)	Tumoral involvement of the papilla (15), duodenal stenosis (31), cannulation failure (17), other (7)	6 mm (60), 8 mm (9), 10 mm (1)	mean 153
Di Mitri et al[35], 2022	Italy	Retrospective, single-center	36	median 75 (IQR, 61-82.5)	Pancreatic cancer (30), duodenal cancer (1), ampullary cancer (2), cholangiocarcinoma (3)	Tumoral involvement of the papilla (9), duodenal stenosis (17), cannulation failure (5), ampulla obscured by prior stents (5)	6 mm (1), 8 mm (24), 10 mm (9), 15 mm (2)	median 160.0 (IQR, 102-205)
Tarantino et al[27], 2021	Italy	Retrospective, single-center	21	NA	Pancreatic cancer (14), duodenal cancer (1), ampullary cancer (3), cholangiocarcinoma (3)	Tumoral involvement of the papilla (12), duodenal stenosis (2), cannulation failure (5), other (2)	6 mm (1), 8 mm (16), 10 mm (3), 15 mm (1)	mean 188.0 (range, 8-554)
Venkatachalapathy et al[34], 2021	United Kingdom	Prospective, multicenter (3)	20	median 76 (range, 65-81)	Pancreatic cancer (12), metastatic cancer (8)	All patients underwent biliary drainage after ERCP failed, but details were not reported	6 mm (3), 8 mm (17)	NA
Garcia-Sumalla et al[36], 20213	Spain	Retrospective, multicenter (3)	39	mean 72.3 (SD, 12.5)	Pancreatic cancer (31), pancreatic neuroendocrine tumor (2), ampullary cancer (3), gastric cardia adenocarcinoma (2), metastatic cancer (1)	Duodenal stenosis (13), cannulation failure (26)	6 mm (19), 8 mm (20)	mean 81.8 (SD, 82.8)
Hindryckx et al[38], 2021	Belgium	Retrospective, single-center	13	NA	NA	NA	NA	NA
Yoo et al[29], 2021	Korea	Retrospective, single-center	7	NA	Malignant distal biliary stricture	Tumoral involvement of the papilla (5), ampulla obscured by prior stents (2)	8 mm (6), 10 mm (1)	NA
Ginestet et al[37], 2022	France	Retrospective, single-center	50	mean 76.5	Pancreatic cancer (43), cholangiocarcinoma (2), ampullary cancer (3), other (2)	Tumoral involvement of the papilla (10), duodenal stenosis (15), cannulation failure (13), other (12)	6 mm (50)	NA
On et al[32], 20224	United Kingdom, Ireland	Retrospective, multicenter (8)	120	median 73.0 (IQR, 17.0)	Pancreatic cancer (77), cholangiocarcinoma (8), ampullary cancer (9), duodenal cancer (14), metastatic cancer (12)	Tumoral involvement of the papilla (32), duodenal stenosis (53), cannulation failure (35)	6 mm (46), 8 mm (68), 10 mm (5)	median 70.0 (range, 3-869)

¹50 cases received double stent placement.

²10 cases received double stent placement.

³17 cases received double stent placement.

⁴32 cases received double stent placement.

CI: Confidence interval; ERCP: Endoscopic retrograde cholangiopancreatography; IPMN: Intraductal papillary mucinous neoplasm; IQR: Interquartile range; NA: Not available; SD: Standard deviation.