Malik Adnan, Malik Muhammad Imran, Amjad Waseem, Javaid Sadia
Mountain Vista Medical Center, 1301 S Crismon Rd, Mesa, AZ 85209, USA.
Department of Hematology specialty, Airedale general hospital, West Yorkshire, England.
Ther Adv Gastrointest Endosc. 2023 Aug 30;16:26317745231192177. doi: 10.1177/26317745231192177. eCollection 2023 Jan-Dec.
Acute calculous cholecystitis (ACC) represents about one-third of all surgical emergencies. The gold standard management of ACC is laparoscopic cholecystectomy. Although cholecystectomy is a safe procedure, it may be dangerous and contraindicated in patients with complex comorbidities. Endoscopic transpapillary gallbladder stenting (ETGBS) and drainage had been widely used to manage patients suffering from ACC with comorbidities.
We searched PubMed, SCOPUS, Web of Science, and Cochrane Library for relevant studies assessing the use of ETGBS in patients suffering from ACC with various comorbidities. Risk of bias assessment was performed using the National Institues of Health (NIH) tool. We included the following outcomes: clinical success, technical success, late complications, and pancreatitis.
We included seven studies that met our inclusion criteria. We found that the pooled proportion of clinical success, technical success, late complications, and pancreatitis was [91.3%, 95% confidence interval (CI) (86.8%, 95.9%)], [92.8%, 95% CI (89%, 96.5%)], [5.4%, 95% CI (2.9%, 7.9%)], and [3.5%, 95% CI (1.2%, 5.8%)], respectively.
We found that an ETGBS was an effective and well-tolerated method for the treatment of cholecystitis, especially in high-risk individuals.
急性结石性胆囊炎（ACC）约占所有外科急症的三分之一。ACC的金标准治疗方法是腹腔镜胆囊切除术。尽管胆囊切除术是一种安全的手术，但对于患有复杂合并症的患者可能存在危险且属禁忌。内镜经乳头胆囊支架置入术（ETGBS）及引流已广泛用于治疗合并症的ACC患者。
我们在PubMed、SCOPUS、科学网和Cochrane图书馆中检索了评估ETGBS在患有各种合并症的ACC患者中应用的相关研究。使用美国国立卫生研究院（NIH）工具进行偏倚风险评估。我们纳入了以下结局：临床成功、技术成功、晚期并发症和胰腺炎。
我们纳入了7项符合纳入标准的研究。我们发现临床成功、技术成功、晚期并发症和胰腺炎的合并比例分别为[91.3%，95%置信区间（CI）（86.8%，95.9%）]、[92.8%，95%CI（89%，96.5%）]、[5.4%，95%CI（2.9%，7.9%）]和[3.5%，95%CI（1.2%，5.8%）]。
我们发现ETGBS是治疗胆囊炎的一种有效且耐受性良好的方法，尤其是在高危个体中。
