EUS-guided hepaticogastrostomy versus EUS-guided hepaticogastrostomy with antegrade stent placement in patients with unresectable malignant distal biliary obstruction: a meta-analysis of individual patient data - Summary - MDSpire

EUS-guided hepaticogastrostomy versus EUS-guided hepaticogastrostomy with antegrade stent placement in patients with unresectable malignant distal biliary obstruction: a meta-analysis of individual patient data

  • By

  • Mahmoud Shaaban Abdelgalil

  • Ahmad Abdelrazek

  • Mahmoud Samir Mohamed

  • Amro Hassan

  • Manar Alaa Mabrouk

  • Mohamed Nasser

  • Eyad Khalil Alhmeid

  • Abdullah Nizar

  • Abid Wazir

  • Noha Ali

  • Adam Hraybi

  • Ryad iqbal

  • Sadia Paracha

  • Shray Amin

  • July 11, 2026

  • 0 min

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Objective:

To systematically compare the efficacy and safety of EUS-HGS alone versus EUS-HGAS in patients with unresectable malignant distal biliary obstruction.

Approach:
  • Literature Search & Study Selection: Comprehensive literature search across Scopus, PubMed, and Web of Science databases up to April 2025, including RCTs and observational studies that met predefined criteria.
  • Screening and Data Extraction: Independent screening of studies using Rayan software and data extraction performed by two authors using a predefined Excel sheet.
  • Quality Assessment: Quality of included observational studies assessed using the Newcastle-Ottawa Scale.
  • Statistical Analysis: Meta-analysis conducted using Review Manager software, with pooled risk ratios, hazard ratios, and mean differences calculated for various outcomes.
Key Findings:
  • EUS-HGAS may provide a longer time to recurrent biliary obstruction compared to EUS-HGS alone.
  • The study included both randomized controlled trials and observational studies.
  • Adverse events were classified based on timing, with early and late events analyzed.
Interpretation:

Limitations:
  • Exclusion of non-English studies may limit the comprehensiveness of the analysis.
  • Potential heterogeneity among included studies could affect the robustness of the results.
Conclusion:

Original Source(s)

EUS-guided hepaticogastrostomy versus EUS-guided hepaticogastrostomy with antegrade stent placement in patients with unresectable malignant distal biliary obstruction: a meta-analysis of individual patient data

  • by Mahmoud Shaaban Abdelgalil, Ahmad Abdelrazek, Mahmoud Samir Mohamed, Amro Hassan, Manar Alaa Mabrouk, Mohamed Nasser, Eyad Khalil Alhmeid, Abdullah Nizar, Abid Wazir, Noha Ali, Adam Hraybi, Ryad iqbal, Sadia Paracha, Shray Amin

  • July 11, 2026

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