To systematically review the available evidence and provide a pooled descriptive analysis of the efficacy and safety of EUS-guided treatment for Afferent Loop Syndrome (ALS).
Approach:
Study Design: A systematic review was performed in accordance with PRISMA principles, searching PubMed/MEDLINE, Embase, and the Cochrane Library for studies reporting EUS-guided gastroenterostomy or enteroenterostomy for ALS.
Eligibility Criteria: Included studies were case reports, case series, and observational studies with extractable outcome data on EUS-guided transmural bypass procedures.
Data Extraction: Data on study design, indication, stent type, technical success, clinical success, adverse events, and follow-up were extracted and synthesized.
Key Findings:
Technical success was achieved in 132/134 patients (98.5%).
Clinical success was reported in 127/134 patients (94.8%).
Adverse events occurred in 13/134 patients (9.7%).
In pooled analysis, technical success rate was 93.5% (95% CI 87.1–96.8; I²=0%) and clinical success rate was 91.0% (95% CI 84.5–94.9; I²=0%).
The overall adverse-event rate was 14.6% (95% CI 9.1–22.5; I²=0%), with common adverse events including procedure-related pain and stent misdeployment.
Interpretation:
Limitations:
The evidence is based on retrospective studies and small sample sizes.
No dedicated pooled analysis of efficacy and safety existed prior to this review.
