了解不同内镜逆行胰胆管造影（ERCP）技术在Roux-en-Y胃旁路术后患者中的作用：一项系统评价和荟萃分析。
Understanding the Role of Different ERCP Techniques in Post-Roux-en-Y Gastric Bypass Patients: a Systematic Review and Meta-analysis.
作者信息
Gellért Bálint, Rancz Anett, Hoferica Jakub, Teutsch Brigitta, Sipos Zoltán, Veres Dániel S, Hegyi Péter Jenő, Ábrahám Szabolcs, Hegyi Péter, Hritz István
机构信息
Centre for Translational Medicine, Semmelweis University, Üllői Út 26, 1085, Budapest, Hungary.
Department of Surgery, Transplantation and Gastroenterology, Division of Interventional Gastroenterology, Semmelweis University, Üllői Út 78, 1082, Budapest, Hungary.
出版信息
Obes Surg. 2025 Jan;35(1):285-304. doi: 10.1007/s11695-024-07459-z. Epub 2024 Dec 13.
We aimed to compare enteroscopy-assisted ERCP (EA-ERCP), laparoscopy-assisted ERCP (LA-ERCP), and endoscopic ultrasound-directed ERCP (EDGE) in terms of safety and efficacy in post-Roux-en-Y gastric bypass patients. We conducted a rigorous analysis based on a predefined protocol (PROSPERO, CRD42022368788). Sixty-seven studies were included. The technical success rates were 77% (CI 69-83%) for EA-ERCP, 93% (CI 91-96%) for LA-ERCP, and 96% (CI 92-98%) for EDGE. Subgroup differences were significant between the EA-ERCP and other groups (p < 0.05). The overall adverse event rates were 13% (CI 8-22%), 19% (CI 14-24%), and 20% (CI 12-31%), respectively (p = 0.49). Our findings suggest that EDGE and LA-ERCP may be more effective and as safe as EA-ERCP.
我们旨在比较经肠镜辅助内镜逆行胰胆管造影术（EA-ERCP）、腹腔镜辅助内镜逆行胰胆管造影术（LA-ERCP）和内镜超声引导下内镜逆行胰胆管造影术（EDGE）在Roux-en-Y胃旁路术后患者中的安全性和有效性。我们根据预先定义的方案（PROSPERO，CRD42022368788）进行了严格的分析。纳入了67项研究。EA-ERCP的技术成功率为77%（可信区间69-83%），LA-ERCP为93%（可信区间91-96%），EDGE为96%（可信区间92-98%）。EA-ERCP组与其他组之间的亚组差异具有统计学意义（p<0.05）。总体不良事件发生率分别为13%（可信区间8-22%）、19%（可信区间14-24%）和20%（可信区间12-31%）（p=0.49）。我们的研究结果表明，EDGE和LA-ERCP可能更有效，且与EA-ERCP一样安全。
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