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经内镜逆行胰胆管造影术用商品化一次性使用十二指肠镜的插管率和技术性能评估:系统评价和荟萃分析。

Cannulation rates and technical performance evaluation of commericially available single-use duodenoscopes for endoscopic retrograde cholangiopancreatography: A systematic review and meta-analysis.

机构信息

Gastroenterology & Hepatology, University of Utah Health, Salt Lake City, UT, USA.

Department of Medicine, Baylor Scott & White Health, Round Rock, TX, USA.

出版信息

Dig Liver Dis. 2024 Jan;56(1):123-129. doi: 10.1016/j.dld.2023.02.022. Epub 2023 Mar 30.

Abstract

BACKGROUND

Single use duodenoscopes were developed to reduce the risk of infection transmission from contaminated reusable duodenoscopes. To this end, we examined various biliary interventions using single use duodenoscopes in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP).

METHODS

Medline, Embase, Scopus, and Cochrane databases were searched from inception through Aug 2022 to identify studies reporting on the performance of single use duodenoscopes for ERCP.

RESULTS

Seven articles were included in the final analysis that included 642 patients (318 males). The Exalt Model D duodenoscope was used in most cases (88.8%) followed by the aScope Duodeno (11.2%) for ERCP. Most ERCPs had a complexity grade of 2 (n = 303) and 3 (n = 198). The pooled cumulative rate of successful cannulation was 95% (95% Confidence Interval (CI): 93-96%, I2=0%, P = 0.46). Sphincterotomy was successfully performed in all cases. The pooled cumulative rate of PEP was 2% (95% CI: 0.4-3.4%, I2=0%, P = 0.80). The pooled cumulative rate of total adverse events was 7% (95% CI: 4-10%, I2=47%, P = 0.08).

CONCLUSIONS

The results of this systematic review and meta-analysis show that single use duodenoscopes are associated with high cannulation rates, technical performance, and safety profile.

摘要

背景

单用途十二指肠镜的开发旨在降低受污染的可重复使用十二指肠镜传播感染的风险。为此,我们在接受内镜逆行胰胆管造影术(ERCP)的患者中检查了各种使用单用途十二指肠镜的胆道介入治疗。

方法

从建库到 2022 年 8 月,我们在 Medline、Embase、Scopus 和 Cochrane 数据库中检索了报告单用途十二指肠镜在 ERCP 中性能的研究。

结果

最终分析纳入了 7 篇文章,共纳入 642 例患者(318 例男性)。大多数情况下使用 Exalt Model D 十二指肠镜(88.8%),其次是 aScope Duodeno(11.2%)进行 ERCP。大多数 ERCP 的复杂性等级为 2(n=303)和 3(n=198)。胰胆管造影术成功插管的累积率为 95%(95%置信区间:93-96%,I2=0%,P=0.46)。所有病例均成功进行了括约肌切开术。PEP 的累积发生率为 2%(95%置信区间:0.4-3.4%,I2=0%,P=0.80)。总的不良事件累积发生率为 7%(95%置信区间:4-10%,I2=47%,P=0.08)。

结论

本系统评价和荟萃分析的结果表明,单用途十二指肠镜具有较高的插管率、技术性能和安全性。

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