两种技术在ERCP选择性胆管插管困难时的系统评价和Meta分析
Systematic Review and Meta-analysis of Two Techniques in Difficult Selective Bile Duct Intubation
王立民 1王良晶 2王新 3郭章允4
作者信息
- 1. 青岛大学,山东 青岛 266000;成武县人民医院消化内科,山东 成武 274200
- 2. 苏州科技城医院消化内科,江苏 苏州 215153
- 3. 成武县人民医院普外科,山东 成武 274200
- 4. 成武县人民医院消化内科,山东 成武 274200
- 折叠
摘要
目的:系统评价胰管预切开技术(TPS)和双导丝技术(DGT)在经内镜逆行胰胆管造影术(ERCP)困难胆道插管中的有效性和安全性.方法:根据纳入和排除标准,由2位研究者使用计算机检索中国知网、万方、维普、PubMed、OVID、Medline和Cochrane数据库,提取关于两种技术在ERCP选择性胆管插管困难时的插管成功率、成功插管时间、术后并发症及胰腺炎的数据,应用RevMan 5.4软件进行Meta分析.结果:纳入12篇文献随机对照研究,共1 033例患者.Meta分析结果显示,在ERCP选择性胆管插管困难时,使用TPS具有更高的胆管插管成功率,差异有统计学意义[RR=1.13,95％CI(1.03,1.24),P=0.01];在成功插管时间、术后总体并发症及ERCP术后胰腺炎方面,差异无统计学意义(P＞0.05).结论:TPS和DGT在选择性胆管插管困难时是两种非常有用的技术,相对于DGT而言,应用TPS有更高的插管成功率.
Abstract
Objective:To conduct a systematic review and meta-analysis to evaluate the effectiveness and security of both double guidewire(DGT)and transpancreatic sphincterotomy techniques(TPS)in difficult biliary cannulation.Methods:Based on inclusion and exclusion criteria,CNKI,VIP,WanFang,PubMed,OVID,Medline and Cochrane were retrieved by two researchers in order to extract the Successful incubation time,overall complications and ERCP postoperative pancreatitis.Using RevMan 5.4 for meta analysis.Results:12 studies were selected.These studies included 1 033 patients.TPS had a significantly higher cannulation success rate when selective bile duct intubation was difficult,and the difference was statistically significant[RR=1.13,95％CI(1.03,1.24),P=0.01].There was no statistically significant difference in successful intubation time,overall complications and ERCP postoperative pancreatitis(P＞0.05).Conclusion:TPS and DGT are two useful techniques in patients with difficult cannulation.TPS have a higher cannulation success rate compared to DGT.
关键词
胰管预切开技术/双导丝技术/经内镜逆行胰胆管造影术/Meta分析Key words
Transpancreatic sphincterotomy technique/Double guidewire technique/ERCP/Meta-analysis引用本文复制引用
基金项目
山东省医药卫生科技发展计划项目(202103030396)
出版年
2024
NETL
NSTL
万方数据