Does periampullary diverticulum affect ERCP cannulation and post-procedure complications? an up-to-date meta-analysis.
Turk J Gastroenterol
; 31(3): 193-204, 2020 03.
Article
em En
| MEDLINE
| ID: mdl-32343231
ABSTRACT
Research conclusions differ on the impact of periampullary diverticulum (PAD) on endoscopic retrograde cholangiopancreatography (ERCP). An up-to-date meta-analysis evaluated the role of PAD in ERCP, especially in terms of cannulation failure and early complications. A comprehensive literature search was performed. All statistical analyses were carried out with the Review Manager 5.3 software. Horizontal lines represented a 95% confidence interval (CI) and the area of each square in forest plots. Twenty-six studies including 23 826 patients with or without PAD who underwent ERCP were evaluated. PAD was associated with an increase in the overall cannulation failure rate (RR=1.46, 95% CI 1.27-1.67; p<.00001), but in the subgroup of studies performed post-2000, PAD was irrelevant to cannulation failure (RR=1.16, 95% CI 0.96-1.41; p=0.12). In overall analyses, PAD was also associated with a high risk of ERCP-related pancreatitis (RR=1.32, 95% CI 1.10-1.59; p=0.003), perforation (RR=1.73, 95% CI 1.06-2.82; p=0.030), and bleeding (RR=1.48, 95% CI 1.13-1.93; p=0.005). The presence of PAD increased the overall cannulation failure rate, but not the rate post-2000. PAD also affected the occurrence of early pancreatitis, perforation, and bleeding.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
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Ampola Hepatopancreática
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Cateterismo
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Colangiopancreatografia Retrógrada Endoscópica
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Divertículo
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Doenças do Ducto Colédoco
Tipo de estudo:
Systematic_reviews
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Turk J Gastroenterol
Ano de publicação:
2020
Tipo de documento:
Article