Journal article
Endoscopic ultrasound-guided antegrade treatment versus balloon enteroscopy endoscopic retrograde cholangiopancreatography for choledocholithiasis in patients with Roux-en-Y gastric bypass: a systematic review and meta-analysis
Annals of gastroenterology, Vol.37(4), pp.493-498
01/01/2024
DOI: 10.20524/aog.2024.0888
PMCID: PMC11226735
PMID: 38974078
Abstract
Background The safety and technical success of endoscopic ultrasound-guided antegrade treatment (EUS-AG) compared to balloon enteroscopy-assisted endoscopic cholangiopancreatography (BE-ERCP) for choledocholithiasis in Roux-en-Y gastrectomy has not been well documented. We performed a systematic review and meta-analysis to assess the safety and efficacy of the 2 procedures. Methods A systematic search of multiple databases was undertaken through January 25, 2024, to identify relevant studies comparing the 2 procedures. Standard meta-analysis methods were employed using a random-effects model. For each outcome, risk-ratio (RR), 95% confidence interval (CI), and P-values were generated. P<0.05 was considered significant. Heterogeneity was assessed using the I-2 statistic. Results Three studies with 795 patients (95 in the EUS-AG group and 700 in the BE-ERCP group) were included. The technical success rate was similar between EUS-AG and BE-ERCP (RR 1.08, 95%CI 0.84-1.38; P=0.57; I-2=56%). The overall rate of adverse effects was higher in the BE-ERCP group than in the EUS-AG group (RR 1.95, 95%CI 1.21-3.15; P=0.006; I-2=0 %). Rates of clinical success, pancreatitis, perforation, and bile peritonitis were similar between the 2 procedure techniques. Conclusions Our analysis showed no distinct advantage in using one technique over the other for patients with Roux-en-Y anatomy in achieving technical and clinical success. However, the incidence of adverse effects was greater in the BE-ERCP group than in the EUS-AG group.
Details
- Title: Subtitle
- Endoscopic ultrasound-guided antegrade treatment versus balloon enteroscopy endoscopic retrograde cholangiopancreatography for choledocholithiasis in patients with Roux-en-Y gastric bypass: a systematic review and meta-analysis
- Creators
- Zohaib Ahmed - University of ToledoAmna Iqbal - University of ToledoMuhammad AzizFatima Iqbal - UNSW SydneyManesh Kumar Gangwani - University of ToledoAbdullah Sohail - University of IowaAmmad Chaudhary - Henry Ford HospitalWade-Lee Smith - University of ToledoUmar Hayat - Geisinger Wyoming Valley Medical CenterShailendra Singh - West Virginia UniversityBabu P. Mohan - Orlando Gastroenterol, Orlando, FL USAToseef Javaid - United Health Services
- Resource Type
- Journal article
- Publication Details
- Annals of gastroenterology, Vol.37(4), pp.493-498
- Publisher
- Hellenic Soc Gastroenterology
- DOI
- 10.20524/aog.2024.0888
- PMID
- 38974078
- PMCID
- PMC11226735
- ISSN
- 1108-7471
- eISSN
- 1792-7463
- Number of pages
- 10
- Language
- English
- Date published
- 01/01/2024
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984694748302771
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