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内镜乳头球囊扩张取石术治疗胆管结石时间延长:系统评价和荟萃分析。

The ballooning time in endoscopic papillary balloon dilation for removal of bile duct stones: A systematic review and meta-analysis.

机构信息

Department of Hepatobiliary Surgery.

Department of Pathology, Luzhou People's Hospital, Luzhou, Sichuan Province.

出版信息

Medicine (Baltimore). 2021 Mar 19;100(11):e24735. doi: 10.1097/MD.0000000000024735.

Abstract

BACKGROUND

So far, there was no consensus regarding balloon dilation time in endoscopic papillary balloon dilation (EPBD). Thus, we conducted a systematic review and meta-analysis to compare the stone removal and overall complication rates of dilation of short and long duration with EPBD.

METHODS

The Cochrane Central Register of Controlled Trials (CENTRAL; Cochrane Library), Web of Science, EMBASE Databases, and PubMed were searched from their inception to December 1, 2019 for all articles regarding balloon dilation time in EPBD for removal of bile duct stones. The data were extracted and the methodology quality was assessed. Meta-analysis was performed using RevMan5.3 software.

RESULTS

Four studies involving a total of 1553 patients were included, 918 in the short dilation group and 635 in the long dilation group. The results of meta-analysis showed that there was no significant difference between the 2 different dilation groups in the complete stone removal in randomized controlled trails (RCTs) group (P = .10) and non-RCTs group (P = 0.45), mechanical lithotripsy requirement (RCTs: P = .92; non-RCTs: P = .47), pancreatitis (RCTs: P = .48; non-RCTs: P = .45), bleeding (RCTs: P = .95; non-RCTs: P = .60), infection of biliary (RCTs: P = .58; non-RCTs: P = .29), perforation (RCTs: P = .32; non-RCTs: P = .37).

CONCLUSION

This systematic review suggests that there no significant difference in the efficacy and safety of dilation of short and long duration for removal of bile duct stones with EPBD.

摘要

背景

到目前为止,内镜乳头球囊扩张术(EPBD)中球囊扩张时间尚无共识。因此,我们进行了系统评价和荟萃分析,比较了短时间和长时间扩张 EPBD 取石的结石清除率和总体并发症发生率。

方法

从成立到 2019 年 12 月 1 日,我们在 Cochrane 中央对照试验注册库(CENTRAL;Cochrane 图书馆)、Web of Science、EMBASE 数据库和 PubMed 上搜索了所有关于 EPBD 中球囊扩张时间用于取胆管结石的文章。提取数据并评估方法学质量。使用 RevMan5.3 软件进行荟萃分析。

结果

共纳入 4 项研究,共 1553 例患者,短扩张组 918 例,长扩张组 635 例。荟萃分析结果显示,在随机对照试验(RCT)组(P=0.10)和非 RCT 组(P=0.45)中,两组不同扩张时间的完全结石清除率、机械碎石术需要(RCTs:P=0.92;非 RCTs:P=0.47)、胰腺炎(RCTs:P=0.48;非 RCTs:P=0.45)、出血(RCTs:P=0.95;非 RCTs:P=0.60)、胆道感染(RCTs:P=0.58;非 RCTs:P=0.29)、穿孔(RCTs:P=0.32;非 RCTs:P=0.37)差异均无统计学意义。

结论

本系统评价提示,EPBD 取石时短时间和长时间扩张的疗效和安全性无显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c257/7982145/78a9ec292d10/medi-100-e24735-g001.jpg

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