• <tr id="yyy80"></tr>
  • <sup id="yyy80"></sup>
  • <tfoot id="yyy80"><noscript id="yyy80"></noscript></tfoot>
  • 99热精品在线国产_美女午夜性视频免费_国产精品国产高清国产av_av欧美777_自拍偷自拍亚洲精品老妇_亚洲熟女精品中文字幕_www日本黄色视频网_国产精品野战在线观看 ?

    Bilateral vs unilateral placement of metal stents for inoperable highgrade hilar biliary strictures: A systemic review and meta-analysis

    2019-09-25 08:12:42MunishAshatSumantAroraJagpalKlairChristopherChildsArvindMuraliFrederickJohlin
    World Journal of Gastroenterology 2019年34期

    Munish Ashat, Sumant Arora, Jagpal S Klair, Christopher A Childs, Arvind R Murali, Frederick C Johlin

    Abstract BACKGROUND Bilateral vs unilateral biliary stenting is used for palliation in malignant biliary obstruction. No clear data is available to compare the efficacy and safety of bilateral biliary stenting over unilateral stenting.AIM To assess the efficacy and safety of bilateral vs unilateral biliary drainage in inoperable malignant hilar obstruction.METHODS PubMed, Embase, Scopus, and Cochrane databases, as well as secondary sources(bibliographic review of selected articles and major GI proceedings), were searched through January 2019. The primary outcome was the re-intervention rate. Secondary outcomes were a technical success, early and late complications,and stent malfunction rate. Pooled odds ratio (OR) and 95% confidence interval(CI) were calculated for each outcome.RESULTS A total of 9 studies were included (2 prospective Randomized Controlled Study,5 retrospective studies, and 2 abstracts), involving 782 patients with malignant hilar obstruction. Bilateral stenting had significantly lower re-intervention rate compared with unilateral drainage (OR = 0.59, 95%CI: 0.40-0.87, P = 0.009). There was no difference in the technical success rate (OR = 0.7, CI: 0.42-1.17, P = 0.17),early complication rate (OR = 1.56, CI: 0.31-7.75, P = 0.59), late complication rate(OR = 0.91, CI: 0.58-1.41, P = 0.56) and stent malfunction (OR = 0.69, CI: 0.42-1.12,P = 0.14) between bilateral and unilateral stenting for malignant hilar biliary strictures.CONCLUSION Bilateral biliary drainage had a lower re-intervention rate as compared to unilateral drainage for high grade inoperable malignant biliary strictures, with no significant difference in technical success, and early or late complication rates.

    Key words: Metal stent; Hilar biliary stricture; Re-intervention rate; Technical success rate

    INTRODUCTION

    Unresectable malignant hilar obstruction (UMHO) is associated with very poor prognosis. Five-year survival is < 10% with most patients dying within 1 year of diagnosis[1,2]. Compared to plastic stents, self-expanding metallic stents (SEMS) have shown to be more cost effective and provides advantage with longer stent patency and less re-intervention rate in patients with non-operable malignancy with score of II to IV on Bismuth-Corlette classification and Hilar cholangiocarcinoma who have a predicted the life expectancy of > 3 mo[3-5]. Biliary stenting also plays a role in the management of obstructive jaundice and cholangitis and is important in enhancing the quality of life of patients with UMHO.

    Although endoscopic stenting is widely favored in cases of UMHO, there is currently no consensus on whether the placement of bilateral biliary stents has any advantage for these patients over unilateral stenting. Although some experts believe in measuring the volume of the liver to be drained to determine the type of stent to be used, quantification of the liver volume is clinically challenging. Furthermore, there have been conflicting data regarding the technical success and outcomes of bilateral and unilateral stenting. While some authors believe that unilateral stenting renders increased technical success rate with concomitant lower complications[6-8]; bilateral stenting, on the other hand, will drain higher liver volume, may have longer stent patency, and hence may require less re-intervention[9-11].

    The aim of the meta-analysis was to systematically review the current literature and compare the efficacy of unilateralvsbilateral stenting in achieving successful stent placement, comparing re-intervention rate, technical success, and early and late procedure-related complications for unresectable malignant hilar strictures.

    MATERIALS AND METHODS

    Data sources and searches

    Search strategies were developed with the assistance of a health sciences librarian with expertise in searching for systematic reviews. Comprehensive search strategies using index and keywords were constructed for PubMed, Embase (Elsevier), and Cinhal (EBSCO). No database filters were used at any time during the searching process. All searches were conducted during January 2019 and the number of citations found in each database can be found in the flow diagram (Figure 1). The searches combined the following concepts: Unilateral SEMS and bilateral SEMS with biliary stents. Within the results for those combined concepts, additional filters, publication types, and keyword strategies were used to identify and exclude the most common articles types that do not report trial results (reviews and case studies). An exhaustive forward search tool was used for the Web of Science database to capture all possible studies of interest. The databases were searched for publications dates 1995 to present.Language limits were applied to search for articles in English only. To identify further articles, references were hand searched. All results were downloaded into EndNote(Thompson ISI Research Soft, Philadelphia, PA, United States), a bibliographic database manager, and duplicate citations were identified and removed. In addition,abstracts from Digestive Disease Week, annual meetings of American College of Gastroenterology, and United European Gastroenterology Week from the last 5 years were also searched.

    Inclusion criteria

    Prospective studies, retrospective studies, and abstracts published in the English language were included if they compared unilateralvsbilateral SEMS biliary stent placement, for one or more of the clinical outcomes: Re-intervention rate, technical success, complication rate, and stent malfunction.

    Exclusion criteria

    Studies were excluded when there was no comparison between unilateral and bilateral stents. We also excluded studies that did not evaluate the required predefined endpoints. Furthermore, duplicate studies, case reports, animal studies, and letters to editors were excluded.

    Data extraction

    Two authors (Ashat M and Arora S) independently extracted the data according to a pre-specified protocol from all the included studies. All discrepancies were resolved after discussion with a third reviewer.

    Quality assessment and risk of bias

    Cohort studies were assessed using the Newcastle-Ottawa Scale and for randomized control trials, Cochrane tool was used to assess for risk of bias[12,13]. Risk of publication bias for each end-point was assessed using the funnel plots.

    Outcome

    The data collected from eligible studies included following data points-publication year, authors, country of publication, study design, mean age of study participants, a total number of patients in each unilateral stenting and bilateral stenting category and type of malignancy, complications rates, and type of complications Supplemental(Table 1).

    Primary end-point of the study was the re-intervention rate. This was defined as an endoscopic or percutaneous intervention that was done for stent failure and to increase biliary drainage or for recurrent jaundice, or for management of dilated intrahepatic bile duct revealed by imaging or management of immediate adverse event of successfully inserted SEMS. Secondary outcomes were (1) Technical success was defined by the successful placement of bilateral or unilateral SEMS across stricture site, confirmed by the flow of contrast or bile through SEMS; (2) Early adverse event rate- defined as early stent-related complications within 4 wk. Early complications included cholangitis, cholecystitis, pancreatitis, bleeding, and liver abscess; (3) Late adverse events were defined as any stent-related complication that occurred after 4 wk of stent insertion. Late complication included cholangitis, cholecystitis, liver abscess; and (4) Stent malfunction defined as stent obstruction due to sludge or stone formation, cholangitis, tumor in-growth, or development of a liver abscess, or biloma.

    Statistical analysis

    Review Manager 5.3 (The Cochrane Collaboration, Oxford, United Kingdom) was used to analyze the data for the meta-analysis. Pooled odds ratios (ORs) and 95%confidence interval (CI) of study end-points were calculated using the Mantel-Haenszel method. In order to access of heterogeneity, we usedX2test (Cochran Q statistic). In case there was significant heterogeneity, a random-effect model was used.Funnel plots were obtained to assess the risk of bias.

    RESULTS

    Using pre-defined parameters and removing duplicate publications our search strategy identified 281 articles. Another 2 articles were identified by manual search. A total of 262 articles were excluded based on our exclusion criterion. Based on our inclusion criterions, 9 studies were selected (Figure 1). Of these 9 studies, 7 were published manuscripts and 2 were published as abstracts. All the baseline characteristics of each individual studies are highlighted in Supplemental Table 1.

    Figure 1 PRISMA diagram of the literature search.

    Study characteristics

    The characteristics of the studies, and of the patients in the selected studies are shown in Supplemental Table 1. A total of 9 studies were enrolled in the current study of which 2 were randomized control trial’s (RCT), and 7 were retrospective trials (5 complete manuscripts and 2 abstracts). Although the study by Mukaiet al[14]was an RCT, for our analysis we used only bilateral stents subgroup of the study which was not randomized. A total of 782 patients were included in the analysis of bilateralvsunilateral biliary stenting.

    Results of meta-analysis

    Primary end-point:Re-intervention rate: A total of 7 studies involving 513 patients was included in this analysis[7,10,14-18]. Bilateral stenting required significantly lower reintervention as compared to unilateral stenting (OR = 0.59, 95%CI: 0.40-0.87,P=0.009) (Figure 2). The funnel plot showed no asymmetry (Figure 3).

    Secondary end-points:(1) Technical success: A total of 8 studies involving 745 patients was included in this analysis[7,10,14,15,17-20]. There was no significant difference in the technical success rate with bilateral stenting as compared to unilateral stenting(OR = 0.7, 95%CI: 0.42-1.17,P= 0.17) (Figure 4). There was mild heterogeneity; (2)Early complications: A total of 5 studies involving 530 patients were included in this analysis[7,10,18-20]. There was no difference between early complications (OR = 1.56,95%CI: 0.31-7.75,P= 0.0001) (Figure 5); (3) Late complications: A total of 5 studies involving 430 patients were included in this analysis[7,10,15,18,20]. There was no difference in late complication rate (OR = 0.91, 95%CI: 0.58-1.41,P= 0.56) (Figure 6); and (4)Stent malfunction: A total of 4 studies involving 324 patients was included in this analysis[7,10,15,18]. There was no difference in stent malfunction rates (OR = 0.69, 95%CI:0.42-1.12,P= 0.14) (Figure 7).

    Quality assessment and funnel plots

    The Newcastle Ottawa Scale score has been provided for all retrospective studies in Supplemental Table 1. The Cochrane collaboration tool assessment of bias for the RCT has been provided in Figure 8. Funnel plots to estimate bias revealed no asymmetry(Figure 3).

    DISCUSSION

    Endoscopic biliary drainage is the intervention of choice in patients with UMHO.Besides providing symptomatic relief to patients with pruritis it also has therapeutic implications with a reduction in total bilirubin which permits the use of subsequent chemotherapy, radiotherapy or photodynamic therapy. This may be important in prolonging the life of patients with unresectable malignant biliary strictures. Over the past decade, multiple studies have found using metallic stents over plastic stents as more cost-effective in hilar cholangiocarcinoma[4,14,21,22]. However, the data comparing bilateralvsunilateral stenting in UMHO is sparse. There has been conflicting data in regards to the outcomes of placement of bilateralvsunilateral SEMS stents[7,8,10,18,23,24].Therefore, we designed this meta-analysis to review the data, thus-far available,comparing bilateralvsunilateral SEMS placement for UMHO. Our meta-analysis shows that bilateral stenting as compared to unilateral stenting is associated with a lower re-intervention rate, but has a comparable technical success rate, early and late complication rates.

    Figure 2 Forest plot of re-intervention rates with bilateral self expanding metal stents vs unilateral stent. SEMS: Self expanding metal stents; OR: Odds ratio;CI: Confidence interval.

    Bilateral stenting was associated with a statistically significant 41% reduction in reintervention rate. There has been marked variability in results among published literature. A prospective trial by Mukaiet al[14]demonstrated 50% re-intervention rate in bilateral SEMS group compared to 29% in unilateral SEMS group. However, the study groups were not treated similarly in their study, as patients who received bilateral stent received sphincterotomy while patients receiving unilateral stent did not. In the prospective RCT by Leeet al[10], the authors showed a statistically significant lower re-intervention rate at 3 mo for bilateral SEMS groupvsunilateral SEMS group (10.9%vs33.3%). The ability to reduce the number of interventions is of paramount importance in patients with non-operable malignant hilar strictures and an average life expectancy < 12 mo, thus avoiding multiple hospitalizations, which inreturn could mean an overall more cost-effective approach and also will have an impact on improving the quality of life for patients[18,25]. Further, restoration of bile flow with bilateral stenting is physiologically more superior to unilateral stenting.Approximately 25%-30% liver needs to be drained in order to satisfactorily reduce jaundice[8,26]. Though unilateral stent should be able to drain at-least 25% of the liver,clinical evidence suggests that up to 30% cases of hilar cholangiocarcinoma are associated with hepatic lobar atrophy[27], and thus in such a situation, unilateral stenting may not provide an appropriate therapeutic response and may increase primary re-intervention rates. Furthermore, a study by Vienneet al[28]suggested that draining more than 50% of the liver volume is an important predictor of the effectiveness of biliary drainage especially in malignant hilar strictures.

    The conflicting data is further complicated by the technical difficulties associated with the placement of bilateral stents. Thus, multiple newer stent delivery systems have been developed to overcome this technical challenge. In our study, there was no significant difference in the technical success between bilateral biliary stenting and unilateral biliary stenting. A meta-analysis by Hong Wet al[24]concluded higher success with unilateral stenting. However, their meta-analysis included studies involving plastic biliary stents which may have affected the results. Our results are similar to results by Naitohet al[18]and Iwanoet al[7]who had similar technical success for bilateral and unilateral stents. Bilateral stents could be placed by either stent-instent technique (SIS) or side-by-side technique (SBS). Naitohet aluse stent in stent technique and Iwanoet alused SIS technique respectively in their patients Although,this meta-analysis did not specifically compare the two techniques of bilateral stenting, a meta-analysis by Naitohet al[18]showed longer stent patency time with SBS group when compared to SIS group. Provider expertise could also account for the variability in the technical success rate among the studies. Thus, based on our results,we believe that bilateral stenting may be preferable for providers who are technically adept at placing both bilateral and unilateral stent.

    Figure 3 Cochrane collaboration tool. Risk assessment.

    Stent malfunction could be driving our primary outcome of stent re-intervention rates. The rate of reintervention was influenced by stent malfunction, however, not all studies defined the cause of stent malfunction clearly (Supplemental Table 2) and hence we only included stent malfunction as a secondary outcome. There was a trend towards decreased stent malfunction with bilateral drainage as compared to unilateral drainage though this was not statistically different. Earlier studies seemed to suggest that bilateral stents could lead to increased stent-related early complications. SBS was associated with increased cholangitis rates and portal vein occlusion because of excessive expansion of the bile duct by parallel stents[18]. SIS deployment could lead to increased sludge formation at the site of stent overlap as a result of a reduction in bile inflow and increase the incidence of tumor ingrowth if the stent mesh is expanded in the area of overlap[17]. In contrast, most recent RCT by Leeet al[10]has shown no difference in rates of cholangitis and liver abscess after bilateral stent placement.Similarly, in our meta-analysis, there was no difference with stent-related early or late complication rates between the two groups.

    There are several limitations to this meta-analysis. The main limitation is that only two studies included in our meta-analysis are RCT’s. Most studies are retrospective studies which could have led to selection bias. Nevertheless, the retrospective studies are reasonable quality cohort studies, as determined by the Modified Newcastle Ottawa quality assessment scale of cohort studies. Another limitation is the presence of significant heterogeneity in some of the analysis. This is likely due to the significant clinical heterogeneity among the studies the differences in the study population, the location of malignant strictures, technical expertise of the providers, and the difference in the duration. However, importantly, there was only mild heterogeneity in the analysis of our primary end-point analysis of re-intervention rate and in the analysis for technical success. For analysis with significant heterogeneity, we used a random effects model to partly account for the clinical heterogeneity. This highlights the need for further research on this topic and the importance of our meta-analysis based on available data.

    In conclusion, bilateral biliary stenting for UMHO may decrease the re-intervention rate in patients with malignant hilar strictures, without increasing early or late complication rate. To the best of our knowledge, this is the first meta-analysis so far comparing the outcomes of SEMS bilateralvsunilateral stenting. Further RCT’s are needed to confirm our findings.

    Figure 4 Forest plot of technical success rates with bilateral self expanding metal stents vs unilateral stent. SEMS: Self expanding metal stents; OR: Odds ratio; CI: Confidence interval.

    Figure 5 Forest plot of early complication rates with bilateral self expanding metal stents vs unilateral stent. SEMS: Self expanding metal stents; OR: Odds ratio; CI: Confidence interval.

    Figure 6 Forest plot of late complication rates with bilateral self expanding metal stents vs unilateral stent. SEMS: Self expanding metal stents; OR: Odds ratio; CI: Confidence interval.

    Figure 7 Forest plot of stent malfunction rates with bilateral self expanding metal stents vs unilateral stent. SEMS: Self expanding metal stents; OR: Odds ratio; CI: Confidence interval.

    Figure 8 Risk of bias summary: Review authors' judgements about each risk of bias item for each included study.

    ARTICLE HIGHLIGHTS

    Research background

    The background, present status, and significance of the study should be described in detail.

    Research motivation

    Over the past few years, newer randomized control trials (RCTs have been published showing the overall advantage of bilateral biliary stenting over unilateral stenting in a subset of patients with inoperable hilar malignant strictures. No meta-analysis was done on this topic with newer study data points.

    Research objectives

    We aimed to conduct a meta-analysis to compare the role of bilateral stentingvsunilateral stenting in inoperable malignant hilar strictures.

    Research methods

    A detailed literature search was conducted to find all the relevant articles. Two reviewers independently analyzed all the selected studies. All discrepancies were discussed independently with the third reviewer and consensus was achieved. We used Pooled odds ratio (OR) and 95%confidence intervals (CIs) were calculated for each outcome.

    Research results

    A total of 782 patients form nine studies were included for analysis. Bilateral stenting had significantly lower re-intervention rate compared with unilateral drainage (OR = 0.59, 95%CI:0.40-0.87, P = 0.009). There was no difference in the technical success rate (OR = 0.7, CI: 0.42-1.17,P = 0.17), early complication rate (OR = 1.56, CI: 0.31-7.75,P= 0.59), late complication rate (OR =0.91, CI: 0.58-1.41, P = 0.56) and stent malfunction (OR = 0.69, CI: 0.42-1.12,P= 0.14) between bilateral and unilateral stenting for malignant hilar biliary strictures.

    Research conclusions

    Older studies that have shown the ease of putting unilateral stenting with fewer complications over bilateral stenting in inoperable malignant hilar strictures. However, with new RCTs showing the higher success of bilateral biliary stenting with lower re-intervention rates, bilateral stenting could offer an overall advantage over unilateral stenting. Our study highlights the overall advantage of bilateral stenting over unilateral stenting.

    Research perspectives

    Biliary stenting is very important modality in the overall management of inoperable malignant hilar strictures. Bilateral stenting offers an advantage over unilateral stenting, however more RCT is required to further support this conclusion.

    国产日韩欧美在线精品| 精品少妇内射三级| 高潮久久久久久久久久久不卡| 黄片播放在线免费| 亚洲国产欧美网| 人成视频在线观看免费观看| 久久天躁狠狠躁夜夜2o2o| 国产成人影院久久av| 日韩大码丰满熟妇| 日本撒尿小便嘘嘘汇集6| 人妻久久中文字幕网| 自拍欧美九色日韩亚洲蝌蚪91| www.精华液| 日韩中文字幕视频在线看片| 精品第一国产精品| 日日摸夜夜添夜夜添小说| 人妻久久中文字幕网| 91老司机精品| 久久香蕉激情| 国产一卡二卡三卡精品| 99在线人妻在线中文字幕 | 欧美人与性动交α欧美精品济南到| av网站在线播放免费| 少妇猛男粗大的猛烈进出视频| 热re99久久精品国产66热6| 一区二区日韩欧美中文字幕| 亚洲精华国产精华精| 精品午夜福利视频在线观看一区 | 精品人妻熟女毛片av久久网站| 最新的欧美精品一区二区| www.精华液| 一边摸一边抽搐一进一出视频| 久久久国产欧美日韩av| 大型av网站在线播放| 可以免费在线观看a视频的电影网站| 王馨瑶露胸无遮挡在线观看| 免费黄频网站在线观看国产| 国产福利在线免费观看视频| 黑人猛操日本美女一级片| 五月天丁香电影| 久久久国产欧美日韩av| 久久久久久久久久久久大奶| svipshipincom国产片| a级毛片黄视频| 久久狼人影院| 久久精品成人免费网站| 淫妇啪啪啪对白视频| 日韩一区二区三区影片| www.999成人在线观看| 成人手机av| 久久国产精品人妻蜜桃| 国产高清视频在线播放一区| 欧美日本中文国产一区发布| 欧美日韩视频精品一区| 脱女人内裤的视频| www.自偷自拍.com| 五月开心婷婷网| 最黄视频免费看| av国产精品久久久久影院| 婷婷成人精品国产| 人人妻人人澡人人爽人人夜夜| 国产精品美女特级片免费视频播放器 | 99国产极品粉嫩在线观看| 女性生殖器流出的白浆| 日韩大片免费观看网站| 一级a爱视频在线免费观看| 久久亚洲精品不卡| 91国产中文字幕| 丰满迷人的少妇在线观看| 麻豆乱淫一区二区| 亚洲国产毛片av蜜桃av| 99精品欧美一区二区三区四区| 亚洲熟妇熟女久久| 电影成人av| 亚洲欧洲日产国产| 亚洲中文字幕日韩| 性高湖久久久久久久久免费观看| 成人国语在线视频| 亚洲精品一卡2卡三卡4卡5卡| 欧美黑人精品巨大| 久久免费观看电影| 国产aⅴ精品一区二区三区波| 精品少妇一区二区三区视频日本电影| 99re6热这里在线精品视频| 日本av免费视频播放| 淫妇啪啪啪对白视频| 飞空精品影院首页| 香蕉丝袜av| 久久久久久亚洲精品国产蜜桃av| 欧美精品啪啪一区二区三区| 18禁国产床啪视频网站| 国产国语露脸激情在线看| 99国产精品99久久久久| 天天影视国产精品| 国产成人精品久久二区二区91| 2018国产大陆天天弄谢| 久久久久久免费高清国产稀缺| 亚洲成av片中文字幕在线观看| 一区在线观看完整版| 啦啦啦在线免费观看视频4| 午夜视频精品福利| 亚洲人成77777在线视频| 99久久精品国产亚洲精品| 午夜福利影视在线免费观看| 国产免费av片在线观看野外av| 午夜福利在线观看吧| 制服人妻中文乱码| 亚洲伊人色综图| 亚洲九九香蕉| 无人区码免费观看不卡 | 俄罗斯特黄特色一大片| 男女下面插进去视频免费观看| 亚洲成人免费电影在线观看| 精品亚洲乱码少妇综合久久| 久久狼人影院| 一个人免费在线观看的高清视频| 后天国语完整版免费观看| 亚洲人成电影免费在线| 性少妇av在线| 色尼玛亚洲综合影院| 国产精品 欧美亚洲| 亚洲色图综合在线观看| av天堂久久9| 欧美大码av| 久久国产精品影院| 久久精品国产亚洲av香蕉五月 | 人妻一区二区av| 交换朋友夫妻互换小说| 中文字幕人妻熟女乱码| 国产av精品麻豆| 男女免费视频国产| av又黄又爽大尺度在线免费看| 99国产精品99久久久久| 国产av精品麻豆| 国产色视频综合| 亚洲国产中文字幕在线视频| 国产老妇伦熟女老妇高清| 在线观看一区二区三区激情| 亚洲精品粉嫩美女一区| 欧美人与性动交α欧美精品济南到| 日日摸夜夜添夜夜添小说| 日本五十路高清| 天堂中文最新版在线下载| 这个男人来自地球电影免费观看| 十分钟在线观看高清视频www| 在线观看免费高清a一片| 超碰97精品在线观看| 久久精品aⅴ一区二区三区四区| 免费高清在线观看日韩| 波多野结衣一区麻豆| 青青草视频在线视频观看| 欧美日韩av久久| 精品福利观看| 99国产极品粉嫩在线观看| 国产男女超爽视频在线观看| 1024视频免费在线观看| 免费av中文字幕在线| 国产精品1区2区在线观看. | 啦啦啦中文免费视频观看日本| 女性被躁到高潮视频| 亚洲第一av免费看| 日韩欧美免费精品| 久久久久国产一级毛片高清牌| 久久99热这里只频精品6学生| 欧美亚洲日本最大视频资源| 亚洲成人国产一区在线观看| 中文欧美无线码| 欧美黄色淫秽网站| 在线观看舔阴道视频| 欧美日韩黄片免| 午夜福利一区二区在线看| 这个男人来自地球电影免费观看| 黑人欧美特级aaaaaa片| 在线 av 中文字幕| 人妻 亚洲 视频| 亚洲黑人精品在线| 最新在线观看一区二区三区| 日韩免费高清中文字幕av| 亚洲伊人色综图| 日本黄色日本黄色录像| 日本a在线网址| 国产成人影院久久av| 黄色怎么调成土黄色| 每晚都被弄得嗷嗷叫到高潮| 国产午夜精品久久久久久| 日本一区二区免费在线视频| 午夜福利视频精品| 老汉色∧v一级毛片| 在线观看人妻少妇| 51午夜福利影视在线观看| 国产欧美日韩综合在线一区二区| 黄色丝袜av网址大全| 国产精品久久久久久精品电影小说| 日韩欧美国产一区二区入口| 亚洲av美国av| 国产在线免费精品| 国产高清视频在线播放一区| 欧美日韩av久久| 黄色怎么调成土黄色| 自线自在国产av| 日韩三级视频一区二区三区| 国产成人影院久久av| 国产日韩一区二区三区精品不卡| 热re99久久精品国产66热6| 欧美黑人欧美精品刺激| 国产黄频视频在线观看| 久久性视频一级片| 免费一级毛片在线播放高清视频 | 久久国产精品影院| 亚洲男人天堂网一区| 欧美乱妇无乱码| 国产成人av激情在线播放| 久久人人97超碰香蕉20202| 十八禁网站免费在线| 又大又爽又粗| 欧美成人免费av一区二区三区 | 黄片播放在线免费| 精品人妻1区二区| 国产亚洲欧美在线一区二区| 在线观看免费日韩欧美大片| 亚洲精品乱久久久久久| 一边摸一边抽搐一进一出视频| 亚洲成人国产一区在线观看| 中文字幕人妻熟女乱码| 国产av国产精品国产| 久久久久久久国产电影| 人人妻人人爽人人添夜夜欢视频| 久久久精品国产亚洲av高清涩受| 久久人妻av系列| 亚洲色图av天堂| 热99久久久久精品小说推荐| 亚洲国产欧美一区二区综合| 性少妇av在线| 国产成人av激情在线播放| 国产男靠女视频免费网站| 日韩欧美免费精品| 国产片内射在线| 久久久精品区二区三区| 一二三四社区在线视频社区8| 欧美成狂野欧美在线观看| 日日摸夜夜添夜夜添小说| 男人舔女人的私密视频| 女人久久www免费人成看片| 国产精品美女特级片免费视频播放器 | 1024视频免费在线观看| 人妻久久中文字幕网| 午夜激情av网站| 亚洲精品久久成人aⅴ小说| 久久久久久久久久久久大奶| 国产aⅴ精品一区二区三区波| 日韩免费av在线播放| 波多野结衣av一区二区av| 国产一区二区激情短视频| 夜夜夜夜夜久久久久| 在线十欧美十亚洲十日本专区| 日韩欧美一区视频在线观看| 成年人黄色毛片网站| 国产99久久九九免费精品| 黄色 视频免费看| 欧美激情极品国产一区二区三区| 中文欧美无线码| 青青草视频在线视频观看| 狠狠精品人妻久久久久久综合| 亚洲av电影在线进入| 中文字幕人妻熟女乱码| 一区二区三区国产精品乱码| 丁香欧美五月| 日本av免费视频播放| 午夜日韩欧美国产| 国产高清激情床上av| 亚洲国产欧美一区二区综合| 久久久久国产一级毛片高清牌| 欧美激情久久久久久爽电影 | 香蕉国产在线看| 精品一区二区三区av网在线观看 | 久久久久精品人妻al黑| 中文字幕人妻熟女乱码| 精品少妇内射三级| 欧美黑人精品巨大| 国产精品成人在线| 亚洲欧洲日产国产| 热99国产精品久久久久久7| 日韩欧美一区二区三区在线观看 | 国产不卡一卡二| 19禁男女啪啪无遮挡网站| 久久精品成人免费网站| 老司机午夜十八禁免费视频| 99九九在线精品视频| 免费少妇av软件| 亚洲av国产av综合av卡| 久久国产精品人妻蜜桃| netflix在线观看网站| 欧美av亚洲av综合av国产av| 一个人免费在线观看的高清视频| 91国产中文字幕| 一级片'在线观看视频| 搡老乐熟女国产| 亚洲熟女毛片儿| videos熟女内射| 久久中文字幕一级| 十分钟在线观看高清视频www| 五月天丁香电影| 免费少妇av软件| 亚洲精品国产精品久久久不卡| 别揉我奶头~嗯~啊~动态视频| 色综合婷婷激情| 国产欧美日韩一区二区三区在线| 亚洲,欧美精品.| 青草久久国产| 国产日韩一区二区三区精品不卡| 成人特级黄色片久久久久久久 | 亚洲人成伊人成综合网2020| 大片免费播放器 马上看| 丁香六月天网| 99国产精品免费福利视频| 视频区图区小说| 岛国在线观看网站| 三上悠亚av全集在线观看| 91麻豆精品激情在线观看国产 | 精品国产超薄肉色丝袜足j| 黑人巨大精品欧美一区二区蜜桃| 美女午夜性视频免费| 欧美人与性动交α欧美精品济南到| 国产成人精品久久二区二区免费| 伊人久久大香线蕉亚洲五| 啪啪无遮挡十八禁网站| 一级毛片女人18水好多| av线在线观看网站| 99精国产麻豆久久婷婷| 狂野欧美激情性xxxx| 亚洲熟女毛片儿| av有码第一页| 自拍欧美九色日韩亚洲蝌蚪91| 妹子高潮喷水视频| a级片在线免费高清观看视频| 视频区图区小说| 一区二区三区国产精品乱码| 久久毛片免费看一区二区三区| 亚洲一卡2卡3卡4卡5卡精品中文| 美女福利国产在线| av线在线观看网站| 久久国产精品大桥未久av| 十分钟在线观看高清视频www| 变态另类成人亚洲欧美熟女 | 国产欧美日韩一区二区精品| 高清欧美精品videossex| 一本一本久久a久久精品综合妖精| 视频区图区小说| 美女国产高潮福利片在线看| 国产欧美日韩精品亚洲av| 亚洲国产av影院在线观看| 香蕉久久夜色| 国产精品香港三级国产av潘金莲| 超色免费av| 精品少妇久久久久久888优播| 99re在线观看精品视频| 嫁个100分男人电影在线观看| 国产人伦9x9x在线观看| 12—13女人毛片做爰片一| 美女高潮喷水抽搐中文字幕| 精品久久久久久电影网| 日韩一区二区三区影片| 啦啦啦 在线观看视频| √禁漫天堂资源中文www| 精品亚洲乱码少妇综合久久| 久久天躁狠狠躁夜夜2o2o| 欧美乱码精品一区二区三区| 国产伦理片在线播放av一区| 性少妇av在线| netflix在线观看网站| 国产精品香港三级国产av潘金莲| 视频在线观看一区二区三区| 久久精品国产综合久久久| 亚洲熟妇熟女久久| 夫妻午夜视频| 国产一区二区三区视频了| 国产有黄有色有爽视频| 亚洲人成伊人成综合网2020| 国产日韩欧美视频二区| 色婷婷av一区二区三区视频| 欧美成人午夜精品| 久久久水蜜桃国产精品网| 人人妻人人澡人人看| 一本综合久久免费| 亚洲精品一二三| 99久久国产精品久久久| 天天躁日日躁夜夜躁夜夜| 久久精品熟女亚洲av麻豆精品| 最黄视频免费看| 9191精品国产免费久久| 国产精品久久久av美女十八| 高清黄色对白视频在线免费看| 日日摸夜夜添夜夜添小说| 欧美+亚洲+日韩+国产| 满18在线观看网站| 搡老乐熟女国产| 日韩免费av在线播放| 色94色欧美一区二区| av又黄又爽大尺度在线免费看| 纯流量卡能插随身wifi吗| 国产色视频综合| 一级黄色大片毛片| 国产欧美日韩一区二区三| 亚洲精品国产一区二区精华液| 国产亚洲一区二区精品| 露出奶头的视频| 精品一区二区三区av网在线观看 | 亚洲精品国产精品久久久不卡| 18禁黄网站禁片午夜丰满| 美女福利国产在线| 亚洲av成人不卡在线观看播放网| 青草久久国产| 动漫黄色视频在线观看| 亚洲精品自拍成人| 在线十欧美十亚洲十日本专区| 国产免费现黄频在线看| 日日夜夜操网爽| 午夜福利一区二区在线看| 人人妻人人澡人人看| 黄色视频在线播放观看不卡| 亚洲精品粉嫩美女一区| 男女高潮啪啪啪动态图| 日本五十路高清| 美女主播在线视频| 黑人巨大精品欧美一区二区mp4| 叶爱在线成人免费视频播放| 啦啦啦在线免费观看视频4| 宅男免费午夜| 熟女少妇亚洲综合色aaa.| 在线观看人妻少妇| 精品国产乱码久久久久久小说| 亚洲熟女毛片儿| av网站免费在线观看视频| 国产在视频线精品| 欧美激情极品国产一区二区三区| 丰满人妻熟妇乱又伦精品不卡| 新久久久久国产一级毛片| 中文字幕人妻熟女乱码| 精品一区二区三区视频在线观看免费 | 18禁黄网站禁片午夜丰满| 成人国产一区最新在线观看| 18禁裸乳无遮挡动漫免费视频| www.自偷自拍.com| 国产区一区二久久| avwww免费| 丰满人妻熟妇乱又伦精品不卡| 日本精品一区二区三区蜜桃| 成人精品一区二区免费| 在线看a的网站| 麻豆成人av在线观看| 一区在线观看完整版| 亚洲 国产 在线| 桃花免费在线播放| av欧美777| 黄片播放在线免费| 国产精品自产拍在线观看55亚洲 | 日本欧美视频一区| 成人影院久久| 99在线人妻在线中文字幕 | 国产亚洲精品第一综合不卡| 国产单亲对白刺激| 国产精品国产av在线观看| 50天的宝宝边吃奶边哭怎么回事| 精品国产一区二区三区久久久樱花| 国产成+人综合+亚洲专区| 国产免费福利视频在线观看| 一边摸一边做爽爽视频免费| 操出白浆在线播放| 国产成人系列免费观看| 亚洲欧洲精品一区二区精品久久久| 欧美日本中文国产一区发布| 欧美 亚洲 国产 日韩一| 一边摸一边抽搐一进一小说 | 老汉色av国产亚洲站长工具| 在线观看舔阴道视频| 在线看a的网站| 老司机在亚洲福利影院| 国产av又大| 乱人伦中国视频| 精品午夜福利视频在线观看一区 | 多毛熟女@视频| 国产欧美日韩精品亚洲av| 搡老熟女国产l中国老女人| 亚洲国产欧美一区二区综合| 丝袜在线中文字幕| 日本撒尿小便嘘嘘汇集6| 久久狼人影院| xxxhd国产人妻xxx| 欧美激情高清一区二区三区| 亚洲欧美激情在线| 久久久精品国产亚洲av高清涩受| 国产高清激情床上av| 脱女人内裤的视频| 狠狠狠狠99中文字幕| 欧美成人午夜精品| 日本vs欧美在线观看视频| 久久精品熟女亚洲av麻豆精品| 高潮久久久久久久久久久不卡| 亚洲九九香蕉| 黄网站色视频无遮挡免费观看| 精品国产一区二区久久| 久久久精品免费免费高清| 亚洲欧美日韩高清在线视频 | 九色亚洲精品在线播放| 欧美乱妇无乱码| 亚洲美女黄片视频| 国产一区二区 视频在线| 90打野战视频偷拍视频| 亚洲精品一卡2卡三卡4卡5卡| 在线观看免费午夜福利视频| 国产淫语在线视频| 日日爽夜夜爽网站| 亚洲av欧美aⅴ国产| 女人被躁到高潮嗷嗷叫费观| 大片电影免费在线观看免费| 成年人免费黄色播放视频| 亚洲专区字幕在线| 亚洲人成电影观看| av天堂在线播放| 伦理电影免费视频| 91成年电影在线观看| 黄色成人免费大全| 亚洲伊人久久精品综合| 国产91精品成人一区二区三区 | 老鸭窝网址在线观看| 悠悠久久av| 亚洲综合色网址| 99在线人妻在线中文字幕 | 精品人妻在线不人妻| 真人做人爱边吃奶动态| 人成视频在线观看免费观看| 在线亚洲精品国产二区图片欧美| 国产激情久久老熟女| 亚洲中文av在线| 国产精品一区二区精品视频观看| 午夜老司机福利片| 两个人免费观看高清视频| 丁香六月欧美| 一级,二级,三级黄色视频| 久久久久久久国产电影| 黑人猛操日本美女一级片| 国产成人精品在线电影| 在线观看66精品国产| 日韩一卡2卡3卡4卡2021年| 少妇被粗大的猛进出69影院| 国产成人免费无遮挡视频| 久久久久久久精品吃奶| 91字幕亚洲| 一级毛片电影观看| 国产精品一区二区在线观看99| 黑人巨大精品欧美一区二区mp4| 日本vs欧美在线观看视频| a级片在线免费高清观看视频| 一本久久精品| 欧美日韩视频精品一区| 国产淫语在线视频| 丝袜美足系列| 一区二区三区精品91| 亚洲美女黄片视频| 精品少妇久久久久久888优播| 99国产精品一区二区蜜桃av | 欧美黄色片欧美黄色片| 亚洲va日本ⅴa欧美va伊人久久| 麻豆国产av国片精品| 国产精品香港三级国产av潘金莲| 窝窝影院91人妻| 亚洲一码二码三码区别大吗| 91字幕亚洲| 国产人伦9x9x在线观看| 中文字幕人妻丝袜制服| 999精品在线视频| 国产激情久久老熟女| 亚洲av电影在线进入| 亚洲中文字幕日韩| 婷婷丁香在线五月| www.999成人在线观看| 不卡av一区二区三区| 国产极品粉嫩免费观看在线| 热99久久久久精品小说推荐| 无限看片的www在线观看| 香蕉国产在线看| 久久精品熟女亚洲av麻豆精品| 精品高清国产在线一区| 免费看十八禁软件| 国产亚洲精品第一综合不卡| 免费在线观看日本一区| 91av网站免费观看| 999精品在线视频| 国产精品欧美亚洲77777| 国产一区二区三区在线臀色熟女 | 亚洲专区字幕在线| 最黄视频免费看| 国产欧美日韩一区二区三| 国产精品久久久久成人av| 操出白浆在线播放| 18禁国产床啪视频网站| 在线十欧美十亚洲十日本专区| bbb黄色大片| 欧美激情 高清一区二区三区| 免费在线观看视频国产中文字幕亚洲| 精品国产乱码久久久久久小说| 国产欧美日韩一区二区三| 热99国产精品久久久久久7| 国产成人av教育| 人妻一区二区av| 亚洲色图av天堂| 十分钟在线观看高清视频www| 啦啦啦 在线观看视频| 一边摸一边做爽爽视频免费| 欧美成人免费av一区二区三区 | 夜夜爽天天搞| 在线观看人妻少妇| 久久 成人 亚洲| 在线观看免费日韩欧美大片| 久久精品熟女亚洲av麻豆精品|