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首页> 外文期刊>Surgical Endoscopy >Double-balloon enteroscopy for diagnostic and therapeutic ERCP in patients with surgically altered gastrointestinal anatomy: a systematic review and meta-analysis
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Double-balloon enteroscopy for diagnostic and therapeutic ERCP in patients with surgically altered gastrointestinal anatomy: a systematic review and meta-analysis

机译：手术改变胃肠解剖学患者诊断和治疗ERCP的双气球肠镜检查：系统评价和荟萃分析

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Background Performing endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically altered gastrointestinal anatomy is challenging. Double-balloon enteroscopy (DBE) has been shown to be safe and efficacious for ERCP in these patients but attempts to synthesize existing data are limited. The purpose of this study was to conduct a systematic review and meta-analysis to evaluate the safety and efficacy of DBE-ERCP in surgically altered anatomy. Methods We searched MEDLINE, EMBASE, and CENTRAL databases through March 2020 for studies that conducted DBE-ERCP in patients with surgically altered gastrointestinal anatomy. Primary outcomes were enteroscopic, diagnostic, and procedural success rates of DBE-ERCP. Secondary outcomes were adverse events after DBE-ERCP. Random effects meta-analysis of proportions was performed when appropriate. The Newcastle-Ottawa scale was used to evaluate risk of bias. Heterogeneity was assessed using the inconsistency (I-2) statistic. Results 24 studies involving 1523 patients were included. The pooled enteroscopic, diagnostic, and procedural success rates of DBE-ERCP were 90% (95% confidence interval (CI), 84-94%), 94% (95% CI 88-98%), and 93% (95% CI 88-97%). Adverse events were reported in 4% (95% CI 3-6%) of cases. Subgroup analysis of short-scope DBE-ERCP (< 200 cm) and long-scope DBE-ERCP (200 cm) did not demonstrate substantial difference in outcomes. Conclusion DBE is safe and efficacious for facilitating ERCP in patients with surgically altered gastrointestinal anatomy, but RCTs or comparative studies are required to clarify its role compared to other modalities in surgically altered anatomy.
机译：背景：对胃肠道解剖结构发生手术改变的患者进行内镜逆行胰胆管造影（ERCP）具有挑战性。双气囊小肠镜（DBE）已被证明对这些患者进行ERCP是安全有效的，但综合现有数据的尝试是有限的。本研究的目的是进行系统回顾和荟萃分析，以评估DBE-ERCP在外科解剖改变中的安全性和有效性。方法我们在MEDLINE、EMBASE和中央数据库中搜索到2020年3月的研究，这些研究在胃肠道解剖结构发生手术改变的患者中进行DBE-ERCP。主要结果是DBE-ERCP的肠镜检查、诊断和操作成功率。次要转归是DBE-ERCP术后的不良事件。适当时对比例进行随机效应荟萃分析。纽卡斯尔-渥太华量表用于评估偏倚风险。异质性采用不一致性（I-2）统计进行评估。结果纳入24项研究，涉及1523名患者。DBE-ERCP的肠道镜、诊断和操作成功率分别为90%（95%可信区间，84-94%）、94%（95%可信区间，88-98%）和93%（95%可信区间，88-97%）。不良事件报告率为4%（95%可信区间3-6%）。短范围DBE-ERCP（<200 cm）和长范围DBE-ERCP（200 cm）的亚组分析结果没有显示出显著差异。结论DBE是一种安全、有效的方法，可用于胃肠道解剖改变患者的ERCP检查，但需要进行RCT或对比研究，以阐明其在胃肠道解剖改变中的作用。

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