Gastrointestinal endoscopy · 2026
Meta-analysis of single session versus two-stage endoscopic ultrasound directed transgastric ERCP (EDGE) in gastric bypass patients.
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Singh Sahib, Sapkota Bishnu, Peleg Noam, Chandan Saurabh, Singh Kelita, John Savio, Akbar Khan Hafiz Muzaffar, Bilal Mohammad, Adler Douglas G
Аннотация
BACKGROUND AND AIMS: Studies have shown variable outcomes when comparing single session endoscopic ultrasound directed transgastric endoscopic retrograde cholangiopancreatography (SS EDGE) and two-stage EDGE. We conducted a meta-analysis.
METHODS: Online databases were searched for studies comparing SS EDGE to two-stage EDGE in patients with gastric bypass. The outcomes of interest were technical success, clinical success, stent dislodgement/migration, overall adverse events (AEs), persistent fistula and patients with weight gain. Pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated.
RESULTS: A total of 7 observational studies with 346 patients (47% SS EDGE, 53% two-stage EDGE) were included. The mean age was 58 years and 23% patients were males. Around 80% EDGE procedures were done for biliary pathologies with the rest being for pancreatic pathologies. When comparing the two approaches, no significant differences were found with respect to technical success (OR 0.34, 95% CI 0.03 to 3.53, p = 0.37), clinical success (OR 1.88, 95% CI 0.38 to 9.17, p = 0.44), stent dislodgement/migration (OR 1.70, 95% CI 0.88 to 3.31, p = 0.12), overall AEs (OR 1.45, 95% CI 0.38 to 5.48, p = 0.58), persistent fistula (OR 1.00, 95% CI 0.32 to 3.09, p = 0.99), and patients with weight gain (OR 1.25, 95% CI 0.32 to 4.84, p = 0.75).
CONCLUSION: SS EDGE and two-stage EDGE were found to have similar outcomes in terms of efficacy and safety.
METHODS: Online databases were searched for studies comparing SS EDGE to two-stage EDGE in patients with gastric bypass. The outcomes of interest were technical success, clinical success, stent dislodgement/migration, overall adverse events (AEs), persistent fistula and patients with weight gain. Pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated.
RESULTS: A total of 7 observational studies with 346 patients (47% SS EDGE, 53% two-stage EDGE) were included. The mean age was 58 years and 23% patients were males. Around 80% EDGE procedures were done for biliary pathologies with the rest being for pancreatic pathologies. When comparing the two approaches, no significant differences were found with respect to technical success (OR 0.34, 95% CI 0.03 to 3.53, p = 0.37), clinical success (OR 1.88, 95% CI 0.38 to 9.17, p = 0.44), stent dislodgement/migration (OR 1.70, 95% CI 0.88 to 3.31, p = 0.12), overall AEs (OR 1.45, 95% CI 0.38 to 5.48, p = 0.58), persistent fistula (OR 1.00, 95% CI 0.32 to 3.09, p = 0.99), and patients with weight gain (OR 1.25, 95% CI 0.32 to 4.84, p = 0.75).
CONCLUSION: SS EDGE and two-stage EDGE were found to have similar outcomes in terms of efficacy and safety.