Author(s): Pei-Jing Cui, Jing Yao, Yi-Jun Zhao, Hua-Zhong Han, Jun Yang, Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Department of Surgery, Sixth People’s Hospital, Shanghai Jiao Tong University
Pages: 14033-14039
Year: 2014 Issue:  38
Journal: World Journal of Gastroenterology
Keyword:  Biliary stent; Endoscopic sphincterotomy; Endoscopic retrograde cholangiopancreatography; Ma-lignant biliary obstruction;
Abstract: AIM:To investigate the benefits of endoscopic sphincterotomy(EST) before stent placement by meta-analysis of randomized controlled trials(RCTs). METHODS:PubMed,EMBASE,Cochrane Library,and Science Citation Index databases up to March 2014 were searched. The primary outcome was incidence of post-endoscopic retrograde cholangiopancreatography(ERCP) pancreatitis(PEP) and successful stent insertion rate. The secondary outcomes were the incidence of post-ERCP bleeding,stent migration and occlusion. The free software Review Manager was used to perform the meta-analysis.RESULTS:Three studies(n=338 patients,170 in the EST group and 168 in the non-EST group)were included.All three studies described a comparison of baseline patient characteristics and showed that there were no statistically significant differences between the two groups.Three RCTs,including 338 patients,were included in this meta-analysis.Most of the analyzed outcomes were similar between the groups.Although EST reduced the incidence of PEP,it also led to a higher incidence of post-ERCP bleeding(OR=0.34,95%CI:0.12-0.93,P=0.04;OR=9.70,95%CI:1.21-77.75,P=0.03,respectively).CONCLUSION:EST before stent placement may be useful in reducing the incidence of PEP.However,ESTrelated complications,such as bleeding and perforation,may offset this effect.