小儿内镜逆行胰胆管造影（ERCP）的适应证、成功率和不良事件发生率：系统评价和荟萃分析。
Indications, success, and adverse event rates of pediatric endoscopic retrograde cholangiopancreatography (ERCP): a systematic review and meta-analysis.
机构信息
Pediatric Gastroenterology, Hepatology, and Nutrition Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
出版信息
BMC Pediatr. 2023 Nov 24;23(1):596. doi: 10.1186/s12887-023-04392-5.
BACKGROUND
To improve knowledge on endoscopic retrograde cholangiopancreatography (ERCP) in children, we aimed to study the proportion of indications, success rate and complication of ERCP.
METHODS
We performed a systematic search of all articles published up to December 2022 in the following databases: Cochrane Library, PubMed (MEDLINE) and Scopus. The meta-analysis was performed using a random-effects model. Heterogeneity was determined by the I statistics and the Cochrane Q test. The included data were analyzed to identify the proportion of indications, success rate and complications of ERCP in children.
RESULTS
Based on data from 52 studies with a total of 5624 participants, the most common indications for ERCP in children were biliary [48% (95% CI: 0.40 - 0.57; I = 98.17%, P < 0.001)] and both biliary and pancreatic [41% (95% CI: 0.33 - 0.49; I = 98.27%, P < 0.001)]. The success rate of ERCP was 95% (95% CI: 0.94 - 0.96; I = 82.53%, P < 0.001) with the overall complication rate of 7% (95% CI: 0.05 - 0.09; I = 82.06%, P < 0.001). The pooled estimate for the incidence of post ERCP pancreatitis was 4% (95% CI: 0.03 - 0.06; I = 85.46%, P < 0.001) and the bleeding was 0% (95% CI: 0.0 - 0.0; I = 28.21%, P = 0.03).
CONCLUSIONS
ERCP appears to be performed safely in children with a similar success rate as in the adult population.
背景
为了提高儿童内镜逆行胰胆管造影术（ERCP）的知识水平，我们旨在研究 ERCP 的适应证比例、成功率和并发症。
方法
我们对截至 2022 年 12 月在以下数据库中发表的所有文章进行了系统检索：Cochrane 图书馆、PubMed（MEDLINE）和 Scopus。使用随机效应模型进行荟萃分析。异质性通过 I 统计量和 Cochrane Q 检验来确定。对纳入的数据进行分析，以确定儿童 ERCP 的适应证比例、成功率和并发症。
结果
基于 52 项研究共 5624 名参与者的数据，儿童 ERCP 最常见的适应证是胆道[48%（95%CI：0.40-0.57；I=98.17%，P<0.001)]和胆道和胰腺[41%（95%CI：0.33-0.49；I=98.27%，P<0.001)]。ERCP 的成功率为 95%（95%CI：0.94-0.96；I=82.53%，P<0.001），总体并发症发生率为 7%（95%CI：0.05-0.09；I=82.06%，P<0.001）。ERCP 后胰腺炎的发生率为 4%（95%CI：0.03-0.06；I=85.46%，P<0.001），出血发生率为 0%（95%CI：0.0-0.0；I=28.21%，P=0.03）。
结论
ERCP 在儿童中似乎是安全的，其成功率与成人人群相似。
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