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Pure cut vs. Endocut in endoscopic biliary sphincterotomy: Systematic review and meta-analysis of randomized clinical trials.
Bicudo de Oliveira, Luiza; Funari, Mateus Pereira; So Taa Kum, Angelo; Bestetti, Alexandre de Moraes; Brunaldi, Vitor Ottoboni; Franzini, Tomazo Antonio Prince; Moura, Eduardo Turiani Hourneaux; Baroni, Luiza Martins; de Carvalho, Matheus Ferreira; Bernardo, Wanderley Marques; de Moura, Eduardo Guimarães Hourneaux.
Afiliação
  • Bicudo de Oliveira L; Gastrointestinal Endoscopy Unit, Division of Gastroenterology, Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo - HC/FMUSP, Sao Paulo, Brazil.
  • Funari MP; Gastrointestinal Endoscopy Unit, Division of Gastroenterology, Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo - HC/FMUSP, Sao Paulo, Brazil.
  • So Taa Kum A; Gastrointestinal Endoscopy Unit, Division of Gastroenterology, Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo - HC/FMUSP, Sao Paulo, Brazil.
  • Bestetti AM; Gastrointestinal Endoscopy Unit, Division of Gastroenterology, Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo - HC/FMUSP, Sao Paulo, Brazil.
  • Brunaldi VO; Gastrointestinal Endoscopy Unit, Division of Gastroenterology, Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo - HC/FMUSP, Sao Paulo, Brazil.
  • Franzini TAP; Surgery and Anatomy Department, Division of Gastrointestinal Surgery, Faculty of Medicine of Ribeirão Preto, Ribeirão Preto, Brazil.
  • Moura ETH; Gastroenterology and Hepatology Division, Mayo Clinic, Rochester, United States.
  • Baroni LM; Gastrointestinal Endoscopy Unit, Division of Gastroenterology, Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo - HC/FMUSP, Sao Paulo, Brazil.
  • de Carvalho MF; Gastrointestinal Endoscopy Unit, Division of Gastroenterology, Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo - HC/FMUSP, Sao Paulo, Brazil.
  • Bernardo WM; Gastrointestinal Endoscopy Unit, Division of Gastroenterology, Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo - HC/FMUSP, Sao Paulo, Brazil.
  • de Moura EGH; Gastrointestinal Endoscopy Unit, Division of Gastroenterology, Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo - HC/FMUSP, Sao Paulo, Brazil.
Endosc Int Open ; 12(7): E830-E841, 2024 Jul.
Article em En | MEDLINE | ID: mdl-38966317
ABSTRACT
Background and study aims Biliary sphincterotomy is a crucial step in endoscopic retrograde cholangiopancreatography (ERCP), a procedure known to carry a 5% to 10% risk of complications. The relationship between Pure cut, Endocut, post-ERCP pancreatitis (PEP) and bleeding is unclear. This systematic review and meta-analysis compared these two current types and their relationships with adverse events. Patients and methods This systematic review involved searching articles in multiple databases until August 2023 comparing pure cut versus Endocut in biliary sphincterotomy. The meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Results A total of 987 patients from four randomized controlled trials were included. Overall pancreatitis A higher risk of pancreatitis was found in the Endocut group than in the Pure cut group ( P =0.001, RD=0.04 [range, 0.01 to 0.06]; I 2 =29%). Overall immediate bleeding Statistical significance was found to favor Endocut, ( P =0.05; RD=-0.15 [range, -0.29 to -0.00]; I 2 =93%). No statistical significance between current modes was found in immediate bleeding without endoscopic intervention ( P =0.10; RD=-0.13 [range, -0.29 to 0.02]; I 2 =88%), immediate bleeding with endoscopic intervention ( P =0.06; RD=-0.07 [range, -0.14 to 0.00]; I 2 =76%), delayed bleeding (P=0.40; RD=0.01 [range, -0.02 to 0.05]; I 2 =72%), zipper cut ( P =0.58; RD=-0.03 [range, -0.16 to 0.09]; I 2 =97%), perforation ( P =1.00; RD=0.00 [range, -0.01 to 0.01]; I 2 =0%) and cholangitis ( P =0.77; RD=0.00 [range, -0.01 to 0.02]; I 2 =29%). Conclusions The available data in the literature show that Endocut carries an increased risk for PEP and does not prevent delayed or clinically significant bleeding, although it prevents intraprocedural bleeding. Based on such findings, Pure cut should be the preferred electric current mode for biliary sphincterotomy.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Endosc Int Open Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Alemanha
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Endosc Int Open Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Alemanha