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首页> 外文期刊>Surgical Endoscopy >Does precut technique improve selective bile duct cannulation or increase post-ERCP pancreatitis rate? A meta-analysis of randomized controlled trials.
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Does precut technique improve selective bile duct cannulation or increase post-ERCP pancreatitis rate? A meta-analysis of randomized controlled trials.

机译：预切技术会改善选择性胆管插管还是增加ERCP后胰腺炎的发生率？一项随机对照试验的荟萃分析。

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摘要

BACKGROUND: There is no clear answer regarding use of precut technique versus conventional method in achieving successful biliary cannulation. OBJECTIVE: To compare the effectiveness of precut technique with that of conventional biliary cannulation by meta-analysis of available randomized controlled trials (RCTs). METHODS: Databases including MEDLINE, EMBASE, Cochrane Library, and Science Citation Index updated to July 2009 were searched. Main outcome measures were success rates of biliary cannulation, incidence of post-endoscopic retrograde cholangiopancreatography (ERCP) complications, and post-ERCP pancreatitis rate. Meta-analysis of these clinical trials was performed. RESULTS: Six RCTs were included. The primary biliary cannulation rate reported with precut and conventional techniques was 89.3 and 78.1%, respectively. Pooled analysis of all selected studies comparing precut cannulation technique with conventional techniques yielded an odds ratio (OR) of 2.05 [95% confidence interval (CI): 0.64-6.63]. Pooled analysis comparing post-ERCP pancreatitis rates for the precut-cannulation groups with those for the conventional-method groups yielded an rate ratio (RR) of 0.46 (95% CI: 0.23-0.92). CONCLUSION: This meta-analysis shows that the precut technique does not increase the primary cannulation rate. However, the technique reduces the risk of post-ERCP pancreatitis compared with conventional technique. Further large, well-performed, randomized controlled studies are needed to confirm these findings.
机译：背景：关于使用预切技术与常规方法来实现成功的胆管插管尚无明确答案。目的：通过对现有随机对照试验（RCT）进行荟萃分析，比较预切技术与常规胆管插管技术的有效性。方法：搜索包括MEDLINE，EMBASE，Cochrane库和更新至2009年7月的《科学引文索引》的数据库。主要结局指标为胆管插管成功率，内镜逆行胰胆管造影术（ERCP）并发症的发生率以及ERCP后胰腺炎的发生率。对这些临床试验进行了荟萃分析。结果：包括六个随机对照试验。预切和常规技术报道的原发性胆管插管率分别为89.3％和78.1％。对所有预选插管技术与常规技术进行比较的研究的汇总分析得出的比值比（OR）为2.05 [95％置信区间（CI）：0.64-6.63]。汇总分析比较了插管前组和常规方法组的ERCP后胰腺炎发生率，得出的比率为（RR）0.46（95％CI：0.23-0.92）。结论：这项荟萃分析表明，预切技术不会增加初次插管率。然而，与传统技术相比，该技术降低了发生ERCP后胰腺炎的风险。需要进一步的大型，性能良好的随机对照研究来证实这些发现。

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