The Efficacy and Safety of Balloon Enteroscopy-Assisted Endoscopic Retrograde Cholangiography in Pediatric Patients with Surgically Altered Gastrointestinal Anatomy

Yokoyama, Kensuke; Yano, Tomonori; Kanno, Atsushi; Ikeda, Etsuko; Ando, Kozue; Miwata, Tetsurou; Nagai, Hirokazu; Kawasaki, Yuki; Tada, Yamato; Sanada, Yukihiro; Tamada, Kiichi; Lefor, Alan Kawarai; Yamamoto, Hironori

doi:10.3390/jcm10173936

Cited by 2 publications

(2 citation statements)

References 31 publications

(34 reference statements)

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“…A systematic review and meta-analysis of Single-balloon enteroscopy (SBE)-assisted ERCP on adult biliary interventions is reported that pooled procedural success rate was 75.8% (95% CI 71.0%-80.3%) [43] . Its feasibility in pediatric patients with surgically altered gastrointestinal anatomy has also been reported recently [44] . Therapeutic ERCP procedures may be a bene cial and alternative treatment for HPB diseases, which success rate in our study is 74%, especially for pediatric patients, because there are considerable risks for them during surgical operations.…”

Section: Discussionmentioning

confidence: 94%

Therapeutic Endoscopic Retrograde Cholangiopancreatography for Pediatric Hepato-Pancreato-Biliary diseases: A Systematic Review and Meta-analysis

Sun

Zheng

et al. 2022

Preprint

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Background: Hepato-pancreato-biliary (HPB) disease has different causes and types between children and adults, which have been diagnosed increasingly in the pediatric group. Endoscopic retrograde cholangiopancreatography (ERCP) has been gradually considered as a therapeutic method in adults, while in pediatric patients, there are not many reports of its usage. This systematic review and meta-analysis aims to assess the use condition of therapeutic ERCP in the management of pediatric HPB diseases.Methods: This systematic literature search was conducted in the PubMed、Embase、Web of Science and the Cochrane library databases to identify all relevant articles published from inception to February 2022 that evaluated therapeutic ERCP in pediatric patients with Hepato-Pancreato-Biliary diseases. The researchers included studies that patients were less than 18 years old and underwent therapeutic ERCP procedures. A random-effects model was used to analyze the usage rate of therapeutic ERCP-procedures, procedural success rates, adverse events rates, and the rate of different therapeutic procedures. Subgroup analysis, sensitivity analysis, and meta-regression were conducted to analyze the source of heterogeneity.Results: A total of 33 articles were included. After homogenization, the overall usage of therapeutic interventions accounts for 77% (95%CI74%-81%) in all ERCP procedures. After excluding outlier studies, the estimation of therapeutic procedure success rate is 74% (95% CI 69 %-79%), adverse events rate is 8% ( 95% CI 6 %-10%). In our study, stent placement is the most common procedure which makes up 75% (95%CI 65%-86%) of all therapeutic procedures. In addition, the usage proportion of sphincterotomy (ST), stone extraction/removal, bougienage/Balloon dilation is respectively 46% (95% CI 39 %-53%), 34% (95% CI 31%-38%), and 26% (95% CI 22%-29%).Conclusions: ERCP procedure is gradually considered as a therapeutic technique in pediatric patients, the proportion of therapeutic ERCP is 77% of total usage, which is increasing by the year. Meanwhile, its success rate is relatively high. It reflects that this operation modality is promising in the treatment of Hepato-pancreato-biliary disorders and is gradually expanded as more branch technologies are being used. A variety of operations can be achieved through ERCP procedures, and more functions should be developed in the future.

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Section: Discussionmentioning

confidence: 94%

Therapeutic Endoscopic Retrograde Cholangiopancreatography for Pediatric Hepato-Pancreato-Biliary diseases: A Systematic Review and Meta-analysis

Sun

Zheng

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…A systematic review and meta-analysis of single-balloon enteroscopy-(SBE-) assisted ERCP on adult biliary interventions reported that pooled procedural success rate was 75.8% (95% CI 71.0-80.3%) (9). Its feasibility in pediatric patients with surgically altered gastrointestinal anatomy has also been reported recently (10). Therapeutic ERCP procedures may be a beneficial and alternative treatment for HPB diseases, whose success rate in our study is 74% (95% CI 69-79%), especially for pediatric patients, because there are considerable risks for them during surgical operations.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic Endoscopic Retrograde Cholangiopancreatography for Pediatric Hepato-Pancreato-Biliary Diseases: A Systematic Review and Meta-Analysis

Sun

Zheng

et al. 2022

Front. Pediatr.

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BackgroundHepato-pancreato-biliary (HPB) disease has different causes and types between children and adults, which has been increasingly diagnosed in the pediatric group. Endoscopic retrograde cholangiopancreatography (ERCP) has been gradually considered as a therapeutic method in adults, while in pediatric patients, there are not many reports of its usage. This systematic review and meta-analysis aims to assess the use condition of therapeutic ERCP in the management of pediatric HPB diseases.MethodsThis systematic literature search was conducted in the PubMed, Embase, Web of Science, and Cochrane library databases to identify all relevant articles published from inception to February 2022 that evaluated therapeutic ERCP in pediatric patients with HPB diseases. The researchers included studies in which patients were less than 18 years old and underwent therapeutic ERCP procedures. A random-effects model was used to analyze the usage rate of therapeutic ERCP procedures, procedural success rates, adverse event rates, and the rate of different therapeutic procedures. Subgroup analysis, sensitivity analysis, and meta-regression were conducted to analyze the source of heterogeneity.ResultsA total of 33 articles were included. After homogenization, the overall use of therapeutic interventions accounts for 77% [95% confidence interval (CI) 74–81%] of all ERCP procedures. After excluding outlier studies, the estimation success rate of the therapeutic procedure is 74% (95% CI 69–79%), and adverse event rate is 8% (95% CI 6–10%). In our study, stent placement is the most common procedure, which makes up 75% (95% CI 65–86%) of all therapeutic procedures. In addition, the usage proportion of sphincterotomy (ST), stone extraction/removal, bougienage/balloon dilation is, respectively, 46% (95% CI 39–53%), 34% (95% CI 31–38%), and 26% (95% CI 22–29%).ConclusionThe ERCP procedure is gradually considered a therapeutic technique in pediatric patients, the proportion of therapeutic ERCP is 77% of total usage, which is increasing every year. Meanwhile, its success rate is relatively high. It reflects that this operation modality is promising in the treatment of HPB disorders and is gradually expanded as more branch technologies are being used. A variety of operations can be achieved through ERCP procedures, and more functions should be developed in the future.Systematic Review Registration[https://www.crd.york.ac.uk/prospero/], identifier [CRD42022302911].

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The Efficacy and Safety of Balloon Enteroscopy-Assisted Endoscopic Retrograde Cholangiography in Pediatric Patients with Surgically Altered Gastrointestinal Anatomy

Cited by 2 publications

References 31 publications

Therapeutic Endoscopic Retrograde Cholangiopancreatography for Pediatric Hepato-Pancreato-Biliary diseases: A Systematic Review and Meta-analysis

Therapeutic Endoscopic Retrograde Cholangiopancreatography for Pediatric Hepato-Pancreato-Biliary diseases: A Systematic Review and Meta-analysis

Therapeutic Endoscopic Retrograde Cholangiopancreatography for Pediatric Hepato-Pancreato-Biliary Diseases: A Systematic Review and Meta-Analysis

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