Evidence map›Paper›PMID 40325242›Full record

SynthesisSurgical endoscopy2025

Evaluating the use of EUS-guided hepaticogastrostomy combined with antegrade stenting for malignant biliary obstruction and comparing to EUS-guided hepaticogastrostomy alone for patients who failed ERCP: a pairwise and single-arm meta-analysis.

Otavio Cosendey Martins, Vanio Antunes, Marcelo Cristalli Pacheco da Costa, Cynthia Florêncio de Mesquita, Tulio L Correa, Matheus Vanzin Fernandes, Natália Junkes Milioli, Stefano Baraldo

Abstract readMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Otavio Cosendey MartinsFederal University of Juiz de Fora, Av. Eugênio do Nascimento, s/n°, Dom Bosco, Juiz de Fora, Minas Gerais, 36038-330, Brazil. otaviocosendey@hotmail.com.ORCID http://orcid.org/0000-0003-2237-2799
Vanio AntunesPorto Alegre Health Sciences Federal University, Porto Alegre, Brazil.
Marcelo Cristalli Pacheco da CostaDepartment of Endoscopy, Unimed Sorocaba, Sorocaba, Brazil.
Cynthia Florêncio de MesquitaFederal University of Pernambuco, Recife, Brazil.
Tulio L CorreaBeth Israel Deaconess Medical Center, Boston, USA.
Matheus Vanzin FernandesPorto Alegre Health Sciences Federal University, Porto Alegre, Brazil.
Natália Junkes MilioliPontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.
Stefano BaraldoDepartment of Endoscopy, Barretos Cancer Hospital, Barretos, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsWhen ERCP is not feasible in the management of malignant biliary obstruction (MBO), endoscopic ultrasound-guided biliary drainage has been proven to be a valuable alternative. EUS-guided hepaticogastrostomy (EUS-HGS) carries a relatively high risk of complications. To mitigate these risks, EUS-guided antegrade stenting combined with EUS-HGS (EUS-HGAS) has been explored. We aimed to conduct a pairwise and a single-arm meta-analysis comparing both techniques and analyzing the efficacy and safety of HGAS for MBO, respectively.

methodsWe systematically searched PubMed, Embase, and Cochrane Library. We included randomized controlled trials or observational studies enrolling patients who underwent EUS-HGAS placement with or without a control group of EUS-HGS without antegrade stenting. We used R statistical software, version 4.4.1.

resultsEight studies were included in the pairwise meta-analysis, and 11 studies were included in the single-arm meta-analysis. Analysis of the need for reintervention showed a significant difference between HGAS and HGS groups, favoring HGAS (p = 0.005), but this group also had a significantly higher rate of pancreatitis (p = 0.027). For HGAS, the pooled analyses demonstrated high technical and clinical success rates (94.06% and 98.05%, respectively); a need for reintervention rate of 8.03%, an overall adverse events rate of 11.67%, mean survival time of 118.53 days, and mean time to stent dysfunction or patient death of 134.61 days.

conclusionThe performance of HGAS in patients who failed ECRP for MBO showed lower need for reintervention rates but higher pancreatitis rates compared to HGS alone. Performing HGAS is associated with high technical and clinical success rates and a low overall adverse event occurrence.

Indexed as

CholestasisDrainageEndosonographyGastrostomyStentsStomachUltrasonography, InterventionalCholangiopancreatography, Endoscopic RetrogradeHumansAntegrade stentingHepaticogastrostomyMalignant biliary obstruction

Identifiers

PMID40325242

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.