Division of Gastroenterology, WellSpan York Hospital, York, Pennsylvania, USA.
Division of Internal Medicine, Geisinger Medical Center, Danville, Pennsylvania, USA.
Gastrointest Endosc. 2023 Dec;98(6):1004-1008. doi: 10.1016/j.gie.2023.07.050. Epub 2023 Aug 5.
The current standard of practice is to use a duodenoscope for the evaluation of the major duodenal papilla (MDP). Recently, cap-assisted endoscopy (CAE), which uses a transparent cap at the tip of a standard front-viewing endoscope, has emerged as an alternative.
A systematic literature search was performed in several databases from inception to January 2023 to identify studies evaluating the efficacy of CAE for the evaluation of the MDP.
Nine studies including 806 patients met our inclusion criteria. The pooled rate of technical success for CAE was 93.2% (95% confidence interval, 85.6-96.9; I = 84.6%). A subgroup analysis comparing CAE with a standard endoscope showed higher odds for the evaluation of the MDP with CAE (but not a duodenoscope, which was better than CAE) with an odds ratio of 57.294 (95% confidence interval, 17.767-184.755; I = 45.303%).
CAE offers a significant advantage with high rates of complete MDP evaluation compared with standard forward-viewing endoscopy. However, CAE is associated with lower rates of success when compared with side-viewing endoscopes.
目前的标准做法是使用十二指肠镜检查主要十二指肠乳头（MDP）。最近，一种名为帽辅助内镜（CAE）的新技术出现了，它在标准前视内镜的尖端使用透明帽。
从创建到 2023 年 1 月，我们在多个数据库中进行了系统文献检索，以确定评估 CAE 检查 MDP 效果的研究。
符合纳入标准的研究有 9 项，共 806 例患者。CAE 的技术成功率为 93.2%（95%置信区间，85.6-96.9；I²=84.6%）。一项比较 CAE 与标准内镜的亚组分析显示，CAE 检查 MDP 的优势更大（但不是十二指肠镜，其优于 CAE），优势比为 57.294（95%置信区间，17.767-184.755；I²=45.303%）。
与标准前视内镜相比，CAE 具有很高的完全 MDP 评估率，这是一个显著的优势。然而，与侧视内镜相比，CAE 的成功率较低。
