Zheng Jin1,2, Yaping Wei2, Xiaowei Tang3, Sisi Shen4, Jing Yang2, Hangbin Jin2, Xiaofeng Zhang2. 1. Hangzhou Geriatric Hospital, Hangzhou First People's Hospital Group, Hangzhou, China. 2. Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China. 3. Affiliated Hospital of Southwest Medical University, Luzhou, China. 4. The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Abstract
BACKGROUND AND AIM: Current evidence supporting the utility of single-operator peroral cholangioscope (SOPOC) in the management of difficult bile duct stones is limited. We conducted the present systematic review and meta-analysis to evaluate the efficacy and safety of SOPOC in treating difficult bile duct stones. METHODS: We searched studies up to April 2018, using MEDLINE, EMBASE, the Cochrane Library, and Google Scholar. Quality assessment of the studies was completed with the Newcastle-Ottawa Scale. Main outcomes were complete stone clearance rate, single-session stone clearance rate, number of endoscopic sessions needed for stone clearance, and adverse events. We calculated the pooled estimates with random-effects models. Potential publication bias was assessed. RESULTS: Twenty-four studies involving 2786 patients met the inclusion criteria. Pooled proportion of patients with complete stone clearance was 94.3% (95% confidence interval [95% CI]: 90.2-97.5%). Single-session stone clearance was achieved in 71.1% (95% CI: 62.1-79.5%) of the pooled patients. Pooled number of sessions needed for stone clearance was 1.26 (95% CI: 1.17-1.34%). Pooled adverse event rate was 6.1% (95% CI: 3.8-8.7%). Potential publication bias was detected but had no significant influence on the results. CONCLUSIONS: Single-operator peroral cholangioscope is an effective and safe treatment for difficult bile duct stones when conventional methods have failed. More randomized controlled trials are warranted to confirm the results.
BACKGROUND AND AIM: Current evidence supporting the utility of single-operator peroral cholangioscope (SOPOC) in the management of difficult bile duct stones is limited. We conducted the present systematic review and meta-analysis to evaluate the efficacy and safety of SOPOC in treating difficult bile duct stones. METHODS: We searched studies up to April 2018, using MEDLINE, EMBASE, the Cochrane Library, and Google Scholar. Quality assessment of the studies was completed with the Newcastle-Ottawa Scale. Main outcomes were complete stone clearance rate, single-session stone clearance rate, number of endoscopic sessions needed for stone clearance, and adverse events. We calculated the pooled estimates with random-effects models. Potential publication bias was assessed. RESULTS: Twenty-four studies involving 2786 patients met the inclusion criteria. Pooled proportion of patients with complete stone clearance was 94.3% (95% confidence interval [95% CI]: 90.2-97.5%). Single-session stone clearance was achieved in 71.1% (95% CI: 62.1-79.5%) of the pooled patients. Pooled number of sessions needed for stone clearance was 1.26 (95% CI: 1.17-1.34%). Pooled adverse event rate was 6.1% (95% CI: 3.8-8.7%). Potential publication bias was detected but had no significant influence on the results. CONCLUSIONS: Single-operator peroral cholangioscope is an effective and safe treatment for difficult bile duct stones when conventional methods have failed. More randomized controlled trials are warranted to confirm the results.
Authors: Facundo Galetti; Diogo Turiani Hourneaux de Moura; Igor Braga Ribeiro; Mateus Pereira Funari; Martin Coronel; Amit H Sachde; Vitor Ottoboni Brunaldi; Tomazo Prince Franzini; Wanderley Marques Bernardo; Eduardo Guimarães Hourneaux de Moura Journal: Arq Bras Cir Dig Date: 2020-06-26