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首页> 外文期刊>Surgical Endoscopy >Forward-viewing endoscope for ERCP in patients with Billroth II gastrectomy: a systematic review and meta-analysis
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Forward-viewing endoscope for ERCP in patients with Billroth II gastrectomy: a systematic review and meta-analysis

机译：Billroth II胃切除术患者的ERCP前瞻性内窥镜：系统评价和荟萃分析

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BackgroundThe forward-viewing endoscope has been increasingly used to perform endoscopic retrograde cholangiopancreatography (ERCP) in patients who underwent Billroth II gastrectomy. This study intended to assess efficacy and safety of the forward-viewing endoscope for ERCP in Billroth II gastrectomy patients compared with conventional side-viewing endoscope using a systematic review and meta-analysis.MethodsA systematic review was conducted for studies that evaluated the outcomes of ERCP for patients with Billroth II gastrectomy. Random-effect model meta-analyses with subgroup analyses were conducted. The methodological quality of the included publications was evaluated using the risk of bias assessment tool for non-randomized studies. The publication bias was assessed.ResultsIn total, 25 studies (1 randomized, 18 retrospective, 1 prospective, and 5 case series studies) with 2446 patients (499 forward-viewing and 1947 side-viewing endoscopes) were analyzed. The pooled afferent loop intubation rate was higher with the forward-viewing endoscope (90.3%, 95% confidence interval (CI) 85.6-93.6 vs. 86.8%, 95% CI 82.8-89.9%). The pooled selective cannulation rate was higher with the side-viewing endoscope (92.3%, 95% CI 88.0-95.2 vs. 91.1%, 95% CI 87.2-93.9%). The pooled bowel perforation rate was higher with the side-viewing endoscope (3.6%, 95% CI 2.3-5.7 vs. 3.0%, 95% CI 1.7-5.3%). The pooled pancreatitis rate was higher with the forward-viewing endoscope (5.4%, 95% CI 3.6-8.0 vs. 2.5%, 95% CI 2.3-5.7%). The pooled bleeding rate was higher with the forward-viewing endoscope (3.0%, 95% CI 1.6-5.5 vs. 2.0%, 95% CI 1.4-3.0%). The heterogeneity among the studies was not significant. The publication bias was minimal.ConclusionThis meta-analysis indicates that the forward-viewing endoscope is as safe and effective as conventional side-viewing endoscope for ERCP in patients with Billroth II gastrectomy.
机译：背景技术前瞻性内窥镜越来越多地用于对患者进行内窥镜逆行胆管痴呆症（ERCP），患者患有白天胃切除术的患者。该研究旨在评估Billroth II胃切除术患者在Billroth II胃切除术患者中对ERCP的疗效和安全性与使用系统评价和META分析进行了常规侧视腔。方法进行了评估ERCP的结果的研究对于白天胃切除术的患者。进行了随机效应模型与子组分析进行的元分析。使用BIAS评估工具的风险评估包括非随机性研究的风险的方法论质量。评估出版物偏见。分析了25例研究（1例随机，18名回顾性，1个前瞻性和5例课程研究），分析了2446名患者（499前景和1947年侧视镜）。汇集传入环管插管率较高，前进内窥镜（90.3％，95％置信区间（CI）85.6-93.6与86.8％，95％CI 82.8-89.9％）。侧视镜内窥镜（92.3％，95％CI 88.0-95.2与91.1％，95％CI 87.2-93.9％），汇集的选择性插管速率较高。侧视镜内窥镜（3.6％，95％CI 2.3-5.7与3.0％，95％CI 1.7-5.3％），汇集肠穿孔率较高。汇集胰腺炎率较高，前视内窥镜（5.4％，95％CI 3.6-8.0与2.5％，95％CI 2.3-5.7％）。汇集的出血率较高，前进内窥镜（3.0％，95％CI 1.6-5.5对2.0％，95％CI 1.4-3.0％）。研究中的异质性并不重要。公布偏倚是最小的。结论该荟萃分析表明前向观察内窥镜与Billroth II胃切除术患者中ERCP的常规侧视内窥镜一样安全有效。

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