Annals of palliative medicine · 2022
Comparing the efficacy of endoscopic balloon dilation alone and combined with endoscopic sphincterotomy for common bile duct stone: a systematic review and meta-analysis.
СтатьяСистематический обзорNetwork Meta-AnalysisНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Hu Jie, Mu Ning, He Yaxi
Аннотация
BACKGROUND: Several comparative studies have shown that endoscopic balloon dilation (EPBD) combined with endoscopic sphincterotomy (EST) may be a better choice than EPBD alone for the treatment of common bile duct stones (CBDS). However, there are limited data that can be used to compare this combination method with EST or EPBD alone in the treatment of choledocholithiasis. Therefore, this study aimed to systematically evaluate the efficacy of EPBD alone and EPBD combined with EST in the treatment of CBDS.
METHODS: We performed a literature search of the PubMed, Cochrane Central Register of Controlled Trials, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang, and Weipu databases using the following search terms: endoscopic balloon dilation, endoscopic sphincterotomy, sphincterotomy, balloon dilation, gallstones, bile duct stones, and common bile duct stones. The Cochrane risk of bias tool was used to evaluate the quality of the included studies, and the network meta-analysis was performed using RevMan 5.20.
RESULTS: A total of nine articles satisfied the inclusion criteria, involving 497 patients who received EST + EPBD and 548 patients who underwent EPBD alone. The results of the meta-analysis showed that compared with the EPBD group, the EST + EPBD group had significant differences in the stone removal time [mean difference (MD) is -1.83; 95% confidence interval (CI): (-3.57, -0.10)] and the initial stone removal rate [relative risk (RR) is 1.11; 95% CI: (1.04, 1.19)]. There were no significant differences in the rate of mechanical vibration stone crushing [RR is 0.74; 95% CI: (0.55, 1.00)], total rate of stone removal [RR is 1.01; 95% CI: (0.98, 1.04)], and complication rate [RR is 0.87; 95% CI: (0.66, 1.13)].
DISCUSSION: The stone removal time and initial stone removal rate of patients in the EST + EPBD group were superior to those of patients in the EPBD group, and the two groups were similar in terms of total stone removal success rate, mechanical lithotripsy (ML) rate, and complication rate. Therefore, large-scale, multi-center prospective studies are needed to clarify whether EST + EPBD is superior to EPBD alone in the treatment of choledocholithiasis.
METHODS: We performed a literature search of the PubMed, Cochrane Central Register of Controlled Trials, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang, and Weipu databases using the following search terms: endoscopic balloon dilation, endoscopic sphincterotomy, sphincterotomy, balloon dilation, gallstones, bile duct stones, and common bile duct stones. The Cochrane risk of bias tool was used to evaluate the quality of the included studies, and the network meta-analysis was performed using RevMan 5.20.
RESULTS: A total of nine articles satisfied the inclusion criteria, involving 497 patients who received EST + EPBD and 548 patients who underwent EPBD alone. The results of the meta-analysis showed that compared with the EPBD group, the EST + EPBD group had significant differences in the stone removal time [mean difference (MD) is -1.83; 95% confidence interval (CI): (-3.57, -0.10)] and the initial stone removal rate [relative risk (RR) is 1.11; 95% CI: (1.04, 1.19)]. There were no significant differences in the rate of mechanical vibration stone crushing [RR is 0.74; 95% CI: (0.55, 1.00)], total rate of stone removal [RR is 1.01; 95% CI: (0.98, 1.04)], and complication rate [RR is 0.87; 95% CI: (0.66, 1.13)].
DISCUSSION: The stone removal time and initial stone removal rate of patients in the EST + EPBD group were superior to those of patients in the EPBD group, and the two groups were similar in terms of total stone removal success rate, mechanical lithotripsy (ML) rate, and complication rate. Therefore, large-scale, multi-center prospective studies are needed to clarify whether EST + EPBD is superior to EPBD alone in the treatment of choledocholithiasis.