Endoscopic Ultrasound

ORIGINAL ARTICLE
Year
: 2019  |  Volume : 8  |  Issue : 4  |  Page : 241--248

Adverse events with lumen-apposing metal stents in endoscopic gallbladder drainage: A systematic review and meta-analysis


Babu P Mohan1, Ravishankar Asokkumar2, Mohammed Shakhatreh3, Rajat Garg4, Suresh Ponnada5, Udayakumar Navaneethan6, Douglas G Adler7 
1 Inpatient Medicine, Banner University Medical Center/ University of Arizona, Tucson, Arizona, USA
2 Division of Gastroenterology and Hepatology, Singapore General Hospital, Singapore
3 Department of Hospital Medicine, Rapides Regional Medical Center, Alexandria, Louisiana, USA
4 Department of Hospital Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA
5 Department of Hospital Medicine, Carilion Roanoke Memorial Hospital, Roanoke, Virginia, USA
6 Center for Interventional Endoscopy, Florida Hospital, Orlando, Florida, USA
7 Division of Gastroenterology and Hepatology, University of Utah School of Medicine, Salt Lake City, Utah, USA

Correspondence Address:
Douglas G Adler
Division of Gastroenterology and Hepatology, Huntsman Cancer Center, University of Utah School of Medicine, 30N 1900E 4R118, Salt Lake City, Utah 84132
USA

Background: Lumen-apposing metal stents (LAMS) are rapidly being used in endoscopic interventional drainage procedures and have started to replace the self-expanding metal stents (SEMSs). Its use in gallbladder drainage (GBD) is limited by lack of good-quality studies, and data are scarce on its safety. Methods: We conducted a comprehensive search of multiple electronic databases and conference proceedings including PubMed, Embase, and Web of Science databases (from inception through July 2018) to identify studies that reported on the use of LAMS in GBD. The outcomes measured were the pooled rates of all adverse events (AEs), pooled rates of early AEs and pooled rates of delayed AEs. Results: A total of 8 studies (393 patients) were included. The pooled rate of all AEs was 12.7% (95% CI 8.4-18.7, I2= 7.7) compared to 17.5% (95% CI 10.2-28.2, I2= 65.1) with other SEMS, P = 0.39. The rate of early AEs with LAMS in endoscopic ultrasound-GBD (EUS-GBD) was 6.5% (95% CI 4.2-10, I2= 1.2), and the rate of delayed AEs was 8.3% (95% CI 5.8-11.9, I2 = 4.8). The rate of recurrent cholecystitis and/or cholangitis was 4.6% (95% CI 2.6-9.5, I2= 0) and the pooled rate of death was 5% (95% CI 2.6-9.5, I2 = 36.4). Conclusion: We report an overall AE rate of 13% with LAMS in EUS-GBD. Early AE risk appears to be 6.5% and delayed AE risk appears to be 8%. Our results are analyzed out of good-quality studies, with minimal to zero heterogeneity.


How to cite this article:
Mohan BP, Asokkumar R, Shakhatreh M, Garg R, Ponnada S, Navaneethan U, Adler DG. Adverse events with lumen-apposing metal stents in endoscopic gallbladder drainage: A systematic review and meta-analysis.Endosc Ultrasound 2019;8:241-248


How to cite this URL:
Mohan BP, Asokkumar R, Shakhatreh M, Garg R, Ponnada S, Navaneethan U, Adler DG. Adverse events with lumen-apposing metal stents in endoscopic gallbladder drainage: A systematic review and meta-analysis. Endosc Ultrasound [serial online] 2019 [cited 2019 Oct 18 ];8:241-248
Available from: http://www.eusjournal.com/article.asp?issn=2303-9027;year=2019;volume=8;issue=4;spage=241;epage=248;aulast=Mohan;type=0