Abstract Biliary drainage for Perihilar Cholangiocarcinoma (PCCA) can be performed either by endoscopic retrograde cholangiopancreatography or Percutaneous Transhepatic Biliary Drainage (PTBD). To date there is no consensus about which method is preferred. Taking that into account, the aim of this study is to compare Endoscopic Biliary Drainage (EBD) versus percutaneous transhepatic biliary drainage in patients with perihilar cholangiocarcinoma through a systematic review and metanalysis. A comprehensive search of multiple electronic databases was performed. Evaluated outcomes included technical success, clinical success, post drainage complications (cholangitis, pancreatitis, bleeding, and major complications), crossover, hospital length stay, and seeding metastases. Data extracted from the studies were used to calculate Mean Differences (MD). Seventeen studies were included, with a total of 2284 patients (EBD = 1239, PTBD = 1045). Considering resectable PCCA, the PTBD group demonstrated lower rates of crossover (RD = 0.29; 95% CI 0.07–0.51; p = 0.009 I2 = 90%), post-drainage complications (RD = 0.20; 95% CI 0.06–0.33; p < 0.0001; I2 = 78%), and post-drainage pancreatitis (RD = 0.10; 95% CI 0.05–0.16; p < 0.0001; I2 = 64%). The EBD group presented reduced length of hospital stay (RD = -2.89; 95% CI -3.35 - -2,43; p < 0.00001; I2 = 42%). Considering palliative PCCA, the PTBD group demonstrated a higher clinical success (RD = -0.19; 95% CI -0.27 - -0.11; p < 0.00001; I2 = 0%) and less post-drainage cholangitis (RD = 0.08; 95% CI 0.01-0.15; p = 0.02; I2 = 48%) when compared to the EBD group. There was no statistical difference between the groups regarding: technical success, post-drainage bleeding, major post-drainage complications, and seeding metastases. PCCA (PCCA PTBD. . (PTBD) preferred account metanalysis cholangitis, (cholangitis bleeding , complications) metastases MD. MD (MD) 228 1239 1045. 1045 1045) RD 0.29 029 0 29 95 0.07–0.51 007051 07 51 0009 009 0.00 I 90%, 90 90% 90%) postdrainage 0.20 020 20 0.06–0.33 006033 06 33 0.0001 00001 0001 78%, 78 78% 78%) 0.10 010 10 0.05–0.16 005016 05 16 64%. 64 64% 64%) 2.89 289 2 89 -2.89 3.35 335 3 35 -3.3 2,43 243 43 -2,43 0.00001 000001 42%. 42 42% 42%) 0.19 019 19 -0.19 0.27 027 27 -0.2 0.11 011 11 -0.11 0% 0.08 008 08 0.010.15 001015 0.01 0.15 01 15 0.01-0.15 0.02 002 02 48% 48 regarding (PTBD (MD 22 123 104 0.2 9 0.07–0.5 00705 5 000 00 0.0 0.06–0.3 00603 0.000 0000 7 0.1 1 0.05–0.1 00501 6 2.8 28 8 -2.8 3.3 -3. 2,4 24 4 -2,4 0.0000 00000 -0.1 -0. 0.010.1 00101 001 015 0.01-0.1 12 0. 0.07–0. 0070 0.06–0. 0060 0.05–0. 0050 2. -2. 3. -3 2, -2, -0 0.010. 0010 0.01-0. 0.07–0 007 0.06–0 006 0.05–0 005 -2 0.010 0.01-0 0.07– 0.06– 0.05– 0.01- 0.07 0.06 0.05

Abstract Non-sharp-pointed foreign bodies that partially obstruct the esophagus require urgent (< 24 h) endoscopic retrieval. In this briefcase report, we report an alternative method of retrieving an unusual foreign object.

Resumen Los cuerpos extraños no puntiagudos que obstruyen parcialmente el esófago requieren una recuperación endoscópica urgente (< 24 horas). En este breve informe de caso, informamos un método alternativo para recuperar un objeto extraño inusual.

Abstract Gastroesophageal varices are a common complication from portal hypertension. Endoscopic variceal banding is currently recommended by guidelines as both therapeutic, in case of hemorrhage, and prophylactic measure. In this brief case report, we try to highlight the importance of proton-pump inhibitors to prevent post-banding ulcer bleeding.

Resumen Las várices gastroesofágicas (VGEs) son una complicación común de la hipertensión portal. La aplicación de bandas en várices por ligadura endoscópica se recomienda actualmente en las guías terapéuticas, en caso de hemorragia, y como medida profiláctica. En este breve informe de caso, tratamos de resaltar la importancia de los inhibidores de la bomba de protones (IBPs) para prevenir el sangrado de úlcera post-ligadura.