EUS-guided hepaticogastrostomy (EUS-HGS) is one of the preferred methods in biliary drainage where ERCP fails or is contraindicated. The clinical outcomes of EUS-HGS are not well studied because of variability in procedure technique. We conducted a search of multiple electronic databases and conference proceedings from inception through January 2023.
View Article and Find Full Text PDFBackground & Aims: Sleeve gastrectomy (SG) is one of the most commonly performed bariatric procedures worldwide. Gastroesophageal reflux disease (GERD) is a major concern in patients undergoing SG and is a risk factor for Barrett's esophagus (BE). We conducted a systematic review and meta-analysis to assess the incidence of and analyze predictive factors for post-SG BE.
View Article and Find Full Text PDFBackground: Bowel ultrasonography (BUS) is emerging as a promising noninvasive tool for assessing disease activity in inflammatory bowel disease (IBD) patients. We evaluated the diagnostic accuracy of BUS in IBD patients against the gold standard diagnostic method, standard colonoscopy.
Methods: Major databases were searched from inception to May 2023 for studies on BUS diagnostic accuracy in IBD.
Conventional endoscopic mucosal resection (C-EMR) is limited by low en-bloc resection rates, especially for large (> 20 mm) lesions. Underwater EMR (U-EMR) has emerged as an alternative for colorectal polyps and is being shown to improve en-bloc resection rates. We conducted a systematic review and meta-analysis comparing the two techniques.
View Article and Find Full Text PDFBackground And Aims: Irritable bowel syndrome (IBS) results in significant loss of quality of life. Management guidelines do not recommend fecal microbiota transplant (FMT) for IBS based on weak evidence as refined data is lacking. We performed a systematic review and meta-analysis to ascertain the pooled clinical outcomes of FMT in IBS, delivered via invasive routes.
View Article and Find Full Text PDFBackground And Aims: Pouchitis is the most common long-term complication after ileal-pouch anal anastomosis in patients with ulcerative colitis. We conducted a systematic review and meta-analysis evaluating the safety and efficacy of fecal microbiota transplant (FMT) in chronic antibiotic dependent and refractory pouchitis.
Methods: Multiple databases were searched through April 2022 for studies that reported the efficacy and safety of FMT in patients with chronic pouchitis.
Barrett's esophagus (BE) is a precursor condition to esophageal adenocarcinoma (EAC), resulting in transformation of the squamous epithelium of distal esophagus to columnar-lined epithelium with intestinal metaplasia (IM). Liquid nitrogen spray cryotherapy (LNSC) is a non-contact method of BE eradication and has been used both as primary and salvage therapy. We conducted a systematic review and meta-analysis to assess the safety and efficacy of LNSC.
View Article and Find Full Text PDFEUS-guided liver biopsy (EUS-LB) has gained momentum in recent years, especially with availability of newer needle designs. Given the emerging comparative data on EUS-LB with second-generation needles and percutaneous LB (PC-LB), we conducted a systematic review and meta-analysis to compare the safety and efficacy of the two techniques. We searched multiple databases from inception through November 2021 to identify studies comparing outcomes of EUS-LB and PC-LB.
View Article and Find Full Text PDFBackground And Aims: Assessment of EUS-guided fine-needle tissue acquisition by macroscopic on-site evaluation (MOSE) is gathering attention. Studies report good diagnostic parameters with MOSE; however, the overall data are limited. We conducted this systematic review and meta-analysis to report on the pooled diagnostic assessment parameters of EUS-guided tissue acquisition by MOSE using fine-needle biopsy sampling (FNB).
View Article and Find Full Text PDFBackground: Crohn's disease (CD) is a chronic progressive condition that is complicated by intestinal or colonic stricture in nearly 30% of cases within 10 years of the initial diagnosis. Endoscopic balloon dilation (EBD) is associated with a risk of perforations and recurrence rates of up to 60% at 5 years. Endoscopic stenting has been used as an alternative to EBD, but data on its safety and efficacy are limited.
View Article and Find Full Text PDFIntroduction And Objectives: The rate of liver transplantation is increasing among the elderly population; however, data is limited on the post-liver transplantation outcomes in patients ≥70 years. Given the scarcity in liver allograft resources, a meta-analysis on the outcomes of liver transplantation in patients ≥70 years is warranted.
Materials And Methods: Multiple databases were searched through March 2022 for studies that reported on the outcomes of liver-transplantation in patients ≥70 years.
Background: Mesenteric panniculitis (MP) is a non-specific, localized inflammation at the mesentery of small intestines which often gets detected on computed tomography. An association with malignant neoplasms remains unclear. We performed a systematic review and meta-analysis to examine the association of malignancy with MP.
View Article and Find Full Text PDFBackground And Aims: Current adenoma detection rate (ADR) benchmarks for colonoscopy in individuals positive for a fecal immunochemical test (FIT) are ≥45% in men and ≥35% in women. These are based on weak, low-quality evidence. We performed a meta-analysis to ascertain the pooled ADR in FIT-positive colonoscopy.
View Article and Find Full Text PDFEUS is an important diagnostic tool in pancreatic lesions. Performance of single-center and/or single study artificial intelligence (AI) in the analysis of EUS-images of pancreatic lesions has been reported. The aim of this study was to quantitatively study the pooled rates of diagnostic performance of AI in EUS image analysis of pancreas using rigorous systematic review and meta-analysis methodology.
View Article and Find Full Text PDFBackground And Aims: Use of hydrogen peroxide (HO) has been reported in direct endoscopic necrosectomy (DEN) of pancreatic walled-off necrosis (WON). The aim of this meta-analysis was to study the pooled clinical outcomes of HO-assisted DEN of pancreatic WON.
Methods: We conducted a comprehensive search of several databases (inception to July 2021) to identify studies reporting on the use of HO in DEN of WON.
Introduction: Colorectal cancer (CRC) screening programs based on the fecal immunochemical test (FIT) and guaiac-based fecal occult blood (gFOBT) are associated with a substantial reduction in CRC incidence and mortality. We conducted a systematic review and comprehensive meta-analysis to evaluate colonoscopy-related adverse events in individuals with a positive FIT or gFOBT.
Methods: A systematic and detailed search was run in January 2021, with the assistance of a medical librarian for studies reporting on colonoscopy-related adverse events as part of organized CRC screening programs.
Patients with cirrhosis are advised to undergo hepatocellular carcinoma (HCC) surveillance every 6 months. Routine surveillance is associated with early tumor detection and improved survival. However, surveillance is underutilized.
View Article and Find Full Text PDFBackground/aims: While safety and effectiveness of advanced endoscopic resection techniques such as endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) has been well established in general population, data regarding their utility in patients with cirrhosis is limited.
Methods: We searched multiple databases from inception through July 2021 to identify studies that reported on outcomes of EMR and/or ESD in patients with cirrhosis. Meta-analysis was performed to determine pooled rates of immediate and delayed bleeding, perforation, death as well as rates of successful en bloc and R0 resection.
Background: Splanchnic vein thrombosis is a well-recognized local vascular complication of acute pancreatitis (AP), estimated to occur in approximately 15% of patients. While splanchnic vein recanalization occurs spontaneously in approximately one third of patients, severe complications such as bowel ischemia and liver failure have also been reported. At present, there is no consensus on whether patients presenting with AP-associated splanchnic vein thrombosis should receive therapeutic anticoagulation.
View Article and Find Full Text PDFHealthcare workers (HCWs) remain on the front line of the battle against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 2019 (COVID-19) infection and are among the highest groups at risk of infection during this raging pandemic. We conducted a systematic review and meta-analysis to assess the incidence of postvaccination SARS-CoV-2 infection among vaccinated HCWs. We searched multiple databases from inception through August 2021 to identify studies that reported on the incidence of postvaccination SARS-CoV-2 infection among HCWs.
View Article and Find Full Text PDFBackground And Aims: Several methods with variable efficacy have been proposed for difficult biliary cannulation in ERCP. We assessed the comparative efficacy of different strategies for difficult biliary cannulation through a network meta-analysis combining direct and indirect treatment comparisons.
Methods: We identified 17 randomized controlled trials (2015 patients) that compared the efficacy of different adjunctive methods for difficult biliary cannulation (needle-knife techniques, pancreatic guidewire-assisted technique, pancreatic-assisted technique, and transpancreatic sphincterotomy) either with each other or with persistence with the standard cannulation techniques.
Background: Modifying patient position during colonoscopy has been proposed as a simple and inexpensive technique to increase luminal distention and improve navigation through the large bowel. The left lateral (LL) decubitus starting position is commonly used during colonoscopy. However, reports indicate that other starting positions may offer additional benefit.
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