학술논문
Performance and safety of percutaneous cholangioscopy: a systematic review and meta-analysis.
Document Type
Academic Journal
Author
Papaefthymiou A; Pancreaticobiliary Medicine Unit, University College London Hospitals (UCLH), London, United Kingdom (Apostolis Papaefthymiou, Kirill Basiliya, Simon Phillpotts, George J. Webster).; Gkolfakis P; Department of Gastroenterology, 'Konstantopoulio-Patision' General Hospital of Nea Ionia, Athens, Greece (Paraskevas Gkolfakis Georgios Tziatzios).; Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme University Hospital, ULB, Brussels, Belgium (Paraskevas Gkolfakis).; Basiliya K; Pancreaticobiliary Medicine Unit, University College London Hospitals (UCLH), London, United Kingdom (Apostolis Papaefthymiou, Kirill Basiliya, Simon Phillpotts, George J. Webster).; Facciorusso A; Gastroenterology Unit, Department of Surgical and Medical Sciences, University of Foggia, Foggia, Italy (Antonio Facciorusso).; Ramai D; Gastroenterology and Hepatology, University of Utah Health, Salt Lake City, UT, USA (Daryl Ramai).; Gerges C; Department of Gastroenterology, University Hospital Essen, Essen, Germany (Christian Gerges).; Tziatzios G; Department of Gastroenterology, 'Konstantopoulio-Patision' General Hospital of Nea Ionia, Athens, Greece (Paraskevas Gkolfakis Georgios Tziatzios).; Phillpotts S; Pancreaticobiliary Medicine Unit, University College London Hospitals (UCLH), London, United Kingdom (Apostolis Papaefthymiou, Kirill Basiliya, Simon Phillpotts, George J. Webster).; Webster GJ; Pancreaticobiliary Medicine Unit, University College London Hospitals (UCLH), London, United Kingdom (Apostolis Papaefthymiou, Kirill Basiliya, Simon Phillpotts, George J. Webster).
Source
Publisher: The Society Country of Publication: Greece NLM ID: 101121847 Publication Model: Print-Electronic Cited Medium: Print ISSN: 1108-7471 (Print) Linking ISSN: 11087471 NLM ISO Abbreviation: Ann Gastroenterol Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
1108-7471
Abstract
Background: Percutaneous cholangioscopy (PerC) offers an alternative for patients with an inaccessible biliary tree. This systematic review and meta-analysis aimed to evaluate the performance of this technique.
Methods: A search in Medline, Cochrane and ClinicalTrials.gov databases was performed for studies assessing PerC up to October 2022. The primary outcome was diagnostic success, defined as successful stone identification or stricture workup. Secondary outcomes included therapeutic success (stone extraction, stenting) and complication rate. A subgroup analysis compared previous-generation and modern cholangioscopes. We performed meta-analyses using a random-effects model and the results were reported as percentages with 95% confidence interval (CI).
Results: Fourteen studies (682 patients) were eligible for analysis. The rate of diagnostic success was 98.7% (95%CI 97.6-99.8%; I2 =31.19%) and therapeutic success was 88.6% (95%CI 82.8-94.3%; I 2 =74.92%). Adverse events were recorded in 17.1% (95%CI 10.7-23.5%; I 2 =77.56%), of which 15.9% (95%CI 9.8-21.9%; I 2 =75.98%) were minor and 0.6% (95%CI 0.1-1.2%; I 2 =0%) major. The Spyglass system showed null heterogeneity for all outcomes; compared with older-generation endoscopes it offered comparable diagnostic success, but yielded significantly superior therapeutic success (96.1%, 95%CI 90-100%; I 2 =0% vs. 86.4%, 95%CI 79.2-93.6%; I 2 =81.41%; P=0.02].
Conclusion: PerC, especially using currently available cholangioscopes, is associated with high diagnostic and therapeutic success.
Competing Interests: Conflict of Interest: GJW has received support from Boston Scientific Inc for teaching and advisory board participation
(Copyright: © Hellenic Society of Gastroenterology.)
Methods: A search in Medline, Cochrane and ClinicalTrials.gov databases was performed for studies assessing PerC up to October 2022. The primary outcome was diagnostic success, defined as successful stone identification or stricture workup. Secondary outcomes included therapeutic success (stone extraction, stenting) and complication rate. A subgroup analysis compared previous-generation and modern cholangioscopes. We performed meta-analyses using a random-effects model and the results were reported as percentages with 95% confidence interval (CI).
Results: Fourteen studies (682 patients) were eligible for analysis. The rate of diagnostic success was 98.7% (95%CI 97.6-99.8%; I
Conclusion: PerC, especially using currently available cholangioscopes, is associated with high diagnostic and therapeutic success.
Competing Interests: Conflict of Interest: GJW has received support from Boston Scientific Inc for teaching and advisory board participation
(Copyright: © Hellenic Society of Gastroenterology.)