Cargando…

Comparison of endoscopic papillary large balloon dilation with and without a prior endoscopic sphincterotomy for the treatment of patients with large and/or multiple common bile duct stones: a systematic review and meta-analysis

AIM: To compare endoscopic papillary large balloon dilation (EPLBD) alone with EPLBD following endoscopic sphincterotomy (EST) in patients with large and/or multiple common bile duct stones. METHODS: We conducted a comprehensive search of PubMed, EMBASE, and the Cochrane Library database to identify...

Descripción completa

Detalles Bibliográficos
Autores principales: Liu, Pan, Lin, Huapeng, Chen, Yuanyuan, Wu, Yu-Shen, Tang, Maocai, Lai, Liang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6331186/
https://www.ncbi.nlm.nih.gov/pubmed/30666119
http://dx.doi.org/10.2147/TCRM.S182615
_version_ 1783387101934387200
author Liu, Pan
Lin, Huapeng
Chen, Yuanyuan
Wu, Yu-Shen
Tang, Maocai
Lai, Liang
author_facet Liu, Pan
Lin, Huapeng
Chen, Yuanyuan
Wu, Yu-Shen
Tang, Maocai
Lai, Liang
author_sort Liu, Pan
collection PubMed
description AIM: To compare endoscopic papillary large balloon dilation (EPLBD) alone with EPLBD following endoscopic sphincterotomy (EST) in patients with large and/or multiple common bile duct stones. METHODS: We conducted a comprehensive search of PubMed, EMBASE, and the Cochrane Library database to identify relevant available articles until July 19, 2018. Complete common bile duct stone (CBDS) removal rate, frequency of mechanical lithotripsy (ML) usage, total procedure time and intra- and postoperative adverse events were analyzed. We used RevMan 5.3 to perform the pooled analyses. RESULTS: Seven RCTs matched the selection criteria. A total of 369 patients underwent EPLBD alone, and 367 patients underwent EPLBD following EST. Our meta-analysis revealed that there were no significant differences in terms of initial success rate (OR =0.69, 95% CI=0.44–1.09, P=0.11), frequency of ML usage (OR =1.18, 95% CI=0.68–2.05, P=0.55), rate of post-endoscopy pancreatitis (PEP) (OR =0.88, 95% CI=0.43–1.78, P=0.72), total procedure time (MD =1.52, 95% CI=-0.13–3.17, P=0.07), or other intra- and postoperative adverse events between the groups for patients with large and/or multiple CBDSs. CONCLUSIONS: EPLBD alone was comparable to EPLBD with prior EST in patients with large and/or multiple CBDSs. Further studies are required to confirm the mechanisms of PEP in patients who accept EPLBD during endoscopic retrograde cholangiopancreatography (ERCP).
format Online
Article
Text
id pubmed-6331186
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Dove Medical Press
record_format MEDLINE/PubMed
spelling pubmed-63311862019-01-21 Comparison of endoscopic papillary large balloon dilation with and without a prior endoscopic sphincterotomy for the treatment of patients with large and/or multiple common bile duct stones: a systematic review and meta-analysis Liu, Pan Lin, Huapeng Chen, Yuanyuan Wu, Yu-Shen Tang, Maocai Lai, Liang Ther Clin Risk Manag Review AIM: To compare endoscopic papillary large balloon dilation (EPLBD) alone with EPLBD following endoscopic sphincterotomy (EST) in patients with large and/or multiple common bile duct stones. METHODS: We conducted a comprehensive search of PubMed, EMBASE, and the Cochrane Library database to identify relevant available articles until July 19, 2018. Complete common bile duct stone (CBDS) removal rate, frequency of mechanical lithotripsy (ML) usage, total procedure time and intra- and postoperative adverse events were analyzed. We used RevMan 5.3 to perform the pooled analyses. RESULTS: Seven RCTs matched the selection criteria. A total of 369 patients underwent EPLBD alone, and 367 patients underwent EPLBD following EST. Our meta-analysis revealed that there were no significant differences in terms of initial success rate (OR =0.69, 95% CI=0.44–1.09, P=0.11), frequency of ML usage (OR =1.18, 95% CI=0.68–2.05, P=0.55), rate of post-endoscopy pancreatitis (PEP) (OR =0.88, 95% CI=0.43–1.78, P=0.72), total procedure time (MD =1.52, 95% CI=-0.13–3.17, P=0.07), or other intra- and postoperative adverse events between the groups for patients with large and/or multiple CBDSs. CONCLUSIONS: EPLBD alone was comparable to EPLBD with prior EST in patients with large and/or multiple CBDSs. Further studies are required to confirm the mechanisms of PEP in patients who accept EPLBD during endoscopic retrograde cholangiopancreatography (ERCP). Dove Medical Press 2019-01-09 /pmc/articles/PMC6331186/ /pubmed/30666119 http://dx.doi.org/10.2147/TCRM.S182615 Text en © 2019 Liu et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Review
Liu, Pan
Lin, Huapeng
Chen, Yuanyuan
Wu, Yu-Shen
Tang, Maocai
Lai, Liang
Comparison of endoscopic papillary large balloon dilation with and without a prior endoscopic sphincterotomy for the treatment of patients with large and/or multiple common bile duct stones: a systematic review and meta-analysis
title Comparison of endoscopic papillary large balloon dilation with and without a prior endoscopic sphincterotomy for the treatment of patients with large and/or multiple common bile duct stones: a systematic review and meta-analysis
title_full Comparison of endoscopic papillary large balloon dilation with and without a prior endoscopic sphincterotomy for the treatment of patients with large and/or multiple common bile duct stones: a systematic review and meta-analysis
title_fullStr Comparison of endoscopic papillary large balloon dilation with and without a prior endoscopic sphincterotomy for the treatment of patients with large and/or multiple common bile duct stones: a systematic review and meta-analysis
title_full_unstemmed Comparison of endoscopic papillary large balloon dilation with and without a prior endoscopic sphincterotomy for the treatment of patients with large and/or multiple common bile duct stones: a systematic review and meta-analysis
title_short Comparison of endoscopic papillary large balloon dilation with and without a prior endoscopic sphincterotomy for the treatment of patients with large and/or multiple common bile duct stones: a systematic review and meta-analysis
title_sort comparison of endoscopic papillary large balloon dilation with and without a prior endoscopic sphincterotomy for the treatment of patients with large and/or multiple common bile duct stones: a systematic review and meta-analysis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6331186/
https://www.ncbi.nlm.nih.gov/pubmed/30666119
http://dx.doi.org/10.2147/TCRM.S182615
work_keys_str_mv AT liupan comparisonofendoscopicpapillarylargeballoondilationwithandwithoutapriorendoscopicsphincterotomyforthetreatmentofpatientswithlargeandormultiplecommonbileductstonesasystematicreviewandmetaanalysis
AT linhuapeng comparisonofendoscopicpapillarylargeballoondilationwithandwithoutapriorendoscopicsphincterotomyforthetreatmentofpatientswithlargeandormultiplecommonbileductstonesasystematicreviewandmetaanalysis
AT chenyuanyuan comparisonofendoscopicpapillarylargeballoondilationwithandwithoutapriorendoscopicsphincterotomyforthetreatmentofpatientswithlargeandormultiplecommonbileductstonesasystematicreviewandmetaanalysis
AT wuyushen comparisonofendoscopicpapillarylargeballoondilationwithandwithoutapriorendoscopicsphincterotomyforthetreatmentofpatientswithlargeandormultiplecommonbileductstonesasystematicreviewandmetaanalysis
AT tangmaocai comparisonofendoscopicpapillarylargeballoondilationwithandwithoutapriorendoscopicsphincterotomyforthetreatmentofpatientswithlargeandormultiplecommonbileductstonesasystematicreviewandmetaanalysis
AT lailiang comparisonofendoscopicpapillarylargeballoondilationwithandwithoutapriorendoscopicsphincterotomyforthetreatmentofpatientswithlargeandormultiplecommonbileductstonesasystematicreviewandmetaanalysis