The efficacy and safety of endoscopic sphincterotomy in patients with Sphincter of Oddi dysfunction: a systematic review and meta-analysis.

Bile duct Endoscopic sphincterotomy Manometry Pancreas Sphincter of Oddi

Journal

Surgical endoscopy
ISSN: 1432-2218
Titre abrégé: Surg Endosc
Pays: Germany
ID NLM: 8806653

Informations de publication

Date de publication:
Dec 2023
Historique:
received: 24 04 2023
accepted: 12 10 2023
pubmed: 15 11 2023
medline: 15 11 2023
entrez: 14 11 2023
Statut: ppublish

Résumé

Sphincter of Oddi dysfunction (SOD) has been used to describe patients with RUQ abdominal pain without an etiology. We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of ES (endoscopic sphincterotomy) for SOD. The study methodology follows the PRISMA guidelines. A comprehensive search was conducted using MEDLINE and EMBASE databases for RCTs with ES in patients with SOD. The primary outcome assessed was the improvement of abdominal pain after ES/sham. A random effects model was used to calculate pooled estimates for each outcome of interest. Of the initial 55 studies, 23 were screened and thoroughly reviewed. The final analysis included 3 studies. 340 patients (89.7% women) with SOD were included. All patients had a cholecystectomy. Most included patients had SOD type II and III. The pooled rate of technical success of ERCP was 100%. The average clinical success rate was 50%. The pooled cumulative rate of overall AEs related to all ERCP procedures was 14.6%. In the sensitivity analysis, only one study significantly affected the outcome or the heterogeneity. ES appears no better than placebo in patients with SOD type III. Sphincterotomy could be considered in patients with SOD type II and elevated SO basal pressure.

Identifiants

pubmed: 37964092
doi: 10.1007/s00464-023-10539-3
pii: 10.1007/s00464-023-10539-3
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

9062-9069

Informations de copyright

© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Auteurs

Jorge A López-Cossio (JA)

Gastroenterology Department, ISSSTE Tijuana, Tijuana, Baja California, Mexico.

Enrique Murcio-Pérez (E)

Departamento de Endoscopia, Centro Medico Nacional Siglo XXI IMSS, Mexico City, México.

Gustavo López Arce-Ángeles (G)

Práctica Privada, Querétaro, Querétaro, Mexico.

Omar D Borjas-Almaguer (OD)

Hospital Christus Muguerza Sur, Monterrey, Nuevo León, Mexico.

Félix Ignacio Téllez-Ávila (FI)

Division of Gastroenterology and Hepatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA. felixtelleza@gmail.com.

Classifications MeSH