Endoscopic retrograde pancreatography-guided versus endoscopic ultrasound-guided technique for pancreatic duct cannulation in patients with pancreaticojejunostomy stenosis: a systematic literature review.

Basiliya, Kirill; Veldhuijzen, Govert; Gerges, Christian; Maubach, Johannes; Will, Uwe; Elmunzer, B Joseph; Stommel, Martijn W J; Akkermans, Reinier; Siersema, Peter D; van Geenen, Erwin-Jan M (2021). Endoscopic retrograde pancreatography-guided versus endoscopic ultrasound-guided technique for pancreatic duct cannulation in patients with pancreaticojejunostomy stenosis: a systematic literature review. Endoscopy, 53(3), pp. 266-276. Thieme 10.1055/a-1200-0199

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BACKGROUND

Stenosis of the pancreaticojejunostomy is a well-known long-term complication of pancreaticoduodenectomy. Traditionally, the endoscopic approach consisted of endoscopic retrograde pancreatography (ERP). Endoscopic ultrasound (EUS)-guided intervention has emerged as an alternative, but the success rate and adverse event rate of both treatment modalities are poorly known. We aimed to compare the outcome data of both interventions.

METHODS

We performed a systematic literature search using the Pubmed/Medline and Embase databases in order to summarize the available data regarding efficacy and complications of ERP- and EUS-guided pancreatic duct (PD) drainage and compare these outcome data using uniform outcome measures in a multilevel logistic model. RESULTS : 13 studies were included, involving 77 patients who underwent ERP-guided drainage, 145 who underwent EUS-guided drainage, and 12 patients who underwent both modalities. An EUS-guided approach was significantly superior to an ERP-guided approach with regard to pancreatic duct opacification (87 % vs. 30 %; P < 0.001), cannulation success (79 % vs. 26 %; P < 0.001), and stent placement (72 % vs. 20 %; P < 0.001). An EUS-guided approach also appeared superior with regard to clinical outcomes such a pain resolution. The adverse event rate between the two treatment modalities could not be compared due to insufficient data. All included studies were found to be of low quality.

CONCLUSION

Based on limited available data, EUS-guided PD intervention appears superior to ERP-guided PD intervention.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine

UniBE Contributor:

Maubach, Johannes Andreas

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0013-726X

Publisher:

Thieme

Language:

English

Submitter:

Rahel Fuhrer

Date Deposited:

22 Dec 2020 17:15

Last Modified:

27 Feb 2021 01:32

Publisher DOI:

10.1055/a-1200-0199

PubMed ID:

32544958

URI:

https://boris.unibe.ch/id/eprint/149308

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