首页|Carbon dioxide insufflation for endoscopic retrograde cholangiopancreatography: A meta-analysis and systematic review
Carbon dioxide insufflation for endoscopic retrograde cholangiopancreatography: A meta-analysis and systematic review
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AIM:To assess the safety and efficacy of carbon dioxide (CO2) insufflation during endoscopic retrograde cholangiopancreatography (ERCP).METHODS:The Cochrane Library,Medical Literature Analysis and Retrieval System Online,Excerpta Medica Database,Science Citation Index Expanded,Chinese Biomedical Literature Database,and references in relevant publications were searched up to December 2011 to identify randomized controlled trials (RCTs)comparing CO2 insufflation with air insufflation during ERCP.The trials were included in the review irrespective of sample size,publication status,or language.Study selection and data extraction were performed by two independent authors.The meta-analysis was performed using Review Manager 5.1.6.A randomeffects model was used to analyze various outcomes.Sensitivity and subgroup analyses were performed if necessary.RESULTS:Seven double-blind RCTs involving a total of 818 patients were identified that compared CO2insuftlation (n =404) with air insufflation (n =401)during ERCR There were a total of 13 post-randomization dropouts in four RCTs.Six RCTs had a high risk of bias and one had a low risk of bias.None of the RCTs reported any severe gas-related adverse events in either group.A meta-analysis of 5 RCTs (n =459)indicated that patients in the CO2 insufflation group had less post-ERCP abdominal pain and distension for at least 1 h compared with patients in the air insufflation group.There were no significant differences in mild cardiopulmonary complications [risk ratio (RR) =0.43,95％ CI:0.07-2.66,P =0.36],cardiopulmonary (e.g.,blood CO2 level) changes [standardized mean difference (SMD) =-0.97,95％ CI:-2.58-0.63,P =0.23],cost analysis (mean difference =3.14,95％ CI:-14.57-20.85,P =0.73),and total procedure time (SMD=-0.05,95％ CI:-0.26-0.17,P =0.67) between the two groups.CONCLUSION:CO2 insufflation during ERCP appears to be safe and reduces post-ERCP abdominal pain and discomfort.
Yao Cheng、Xian-Ze Xiong、Si-Jia Wu、Jiong Lu、Yi-Xin Lin、Nan-Sheng Cheng、Tai-Xiang Wu
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Department of Bile Duct Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Chinese Cochrane Centre, Chinese Clinical Trial Registry, Chinese Evidence-Based Medicine Centre, INCLEN Resource and Training Centre, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
NETL
NSTL
万方数据
维普
