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用于清除胆总管结石的球囊导管与网篮导管的疗效:一项系统评价和荟萃分析。

Outcomes of balloon vs basket catheter for clearance of choledocholithiasis: a systematic review and meta-analysis.

作者信息

Sharma Ruchi, Sharma Vikram, Singhal Umang, Sanaka Madhusudhan

机构信息

Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States.

Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, United States.

出版信息

Endosc Int Open. 2022 Nov 15;10(11):E1447-E1453. doi: 10.1055/a-1905-0251. eCollection 2022 Nov.

Abstract

Endoscopic retrograde cholangiopancreatography (ERCP) is the mainstay for treatment of choledocholithiasis. It is unclear whether balloon or basket catheters are better for extraction of stones ≤ 10 mm in size. We performed a meta-analysis of studies comparing rates of complete stone extraction and adverse events after ERCP using balloon vs basket catheters for bile duct stones ≤ 10 mm in size.  Cochrane database, PubMed, Web of Science, and Embase were searched from inception to October 2021. Randomized control trials comparing outcomes of balloon vs basket catheter were included. Data extraction of articles was carried out by two authors using predefined inclusion criteria. Metanalysis was carried out using the Revman 5.4.1. software using a random-effects model.  Three studies with a total of 508 patients were included in the final analysis. For common bile duct stones ≤ 10 mm, balloon catheters had higher complete stone clearance rates than basket catheters (relative risk 1.1, confidence interval 1.03, 1.18,  = 0.006). Heterogeneity among studies was low (Tau  = 0.0;  = 0.47, I  = 0 %). There was no difference in the rate of complications.  Meta-analysis of three studies indicates that balloon catheters have a higher success rate compared to basket catheters for complete stone extraction for choledocholithiasis ≤ 10 mm with no significant difference in the rate of complications.

摘要

内镜逆行胰胆管造影术(ERCP)是治疗胆总管结石的主要方法。目前尚不清楚球囊导管和网篮导管哪种更适合取出直径≤10mm的结石。我们对比较使用球囊导管与网篮导管进行ERCP后取出直径≤10mm胆管结石的完全结石取出率和不良事件发生率的研究进行了荟萃分析。从数据库建立至2021年10月,检索了Cochrane数据库、PubMed、科学网和Embase。纳入比较球囊导管与网篮导管结果的随机对照试验。由两名作者使用预定义的纳入标准对文章进行数据提取。使用Revman 5.4.1软件采用随机效应模型进行荟萃分析。最终分析纳入了三项研究,共508例患者。对于直径≤10mm的胆总管结石,球囊导管的完全结石清除率高于网篮导管(相对危险度1.1,置信区间1.03,1.18,P = 0.006)。研究间异质性较低(Tau = 0.0;P = 0.47,I² = 0%)。并发症发生率无差异。三项研究的荟萃分析表明,对于直径≤10mm的胆总管结石,球囊导管在完全结石取出方面的成功率高于网篮导管,并发症发生率无显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f67/9666065/2b5fa83bf2bd/10-1055-a-1905-0251-i2693ei1.jpg

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