Journal article
Effectiveness and Safety of EUS Rendezvous After Failed Biliary Cannulation With ERCP: A Systematic Review and Proportion Meta-analysis
Journal of clinical gastroenterology, Vol.57(2), pp.211-217
02/01/2023
DOI: 10.1097/MCG.0000000000001543
PMID: 34009843
Abstract
Endoscopic ultrasound-guided rendezvous (EUS-RV) endoscopic retrograde cholangiopancreatography (ERCP) is an alternative to interventional radiology-guided rendezvous ERCP in patients who failed biliary cannulation with conventional ERCP. However, there is significant variation in reported rates of success and adverse events associated with EUS-RV-assisted ERCP. We performed a systematic review and a proportion meta-analysis to reliably assess the effectiveness and safety of the EUS-RV-assisted ERCP.
We conducted a comprehensive search of multiple electronic databases and conference proceedings (from inception through August 2020) to identify studies reporting EUS-RV-assisted ERCP in patients who failed biliary cannulation with conventional ERCP techniques. Using the random-effects model described by DerSimonian and Laird, we calculated the pooled rates of technical success, clinical success, and adverse events of EUS-RV-assisted ERCP.
Twelve studies reporting a total of 342 patients were included in the meta-analysis. The pooled rate of technical success (12 studies reporting a total of 342 patients) was 86.1% [95% confidence interval (CI): 78.4-91.3]. The pooled rate of clinical success (4 studies reporting a total of 94 patients) was 80.8% (95% CI: 64.1-90.8). The pooled rate of overall adverse events (12 studies; 42 events in 342 patients) was 14% (95% CI: 10.5-18.4). Low to moderate heterogeneity was noted in the analyses.
EUS-RV-assisted ERCP appears to be effective and safe in patients who failed biliary cannulation with conventional ERCP. Given the risk of adverse events, it should be performed in centers with expertise in therapeutic endoscopic ultrasound.
Details
- Title: Subtitle
- Effectiveness and Safety of EUS Rendezvous After Failed Biliary Cannulation With ERCP: A Systematic Review and Proportion Meta-analysis
- Creators
- Jagpal S Klair - University of IowaYousaf Zafar - Department of Internal Medicine, University of Central Florida, Orlando, FLMunish Ashat - University of IowaShivanand Bomman - Virginia Mason Medical CenterArvind R Murali - University of IowaMahendran Jayaraj - University of Nevada, Las VegasJoanna Law - Virginia Mason Medical CenterMichael Larsen - Virginia Mason Medical CenterDhruv P Singh - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MNTarun Rustagi - Division of Gastroenterology and Hepatology, University of New Mexico, Albuquerque, NMShayan Irani - Virginia Mason Medical CenterAndrew Ross - Virginia Mason Medical CenterRichard Kozarek - Virginia Mason Medical CenterRajesh Krishnamoorthi - Virginia Mason Medical Center
- Resource Type
- Journal article
- Publication Details
- Journal of clinical gastroenterology, Vol.57(2), pp.211-217
- DOI
- 10.1097/MCG.0000000000001543
- PMID
- 34009843
- ISSN
- 1539-2031
- eISSN
- 1539-2031
- Language
- English
- Date published
- 02/01/2023
- Academic Unit
- Gastroenterology and Hepatology; Internal Medicine
- Record Identifier
- 9984359902402771
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