Endoscopic Papillary Large Balloon Dilation Reduces the Need for Mechanical Lithotripsy in Patients with Large Bile Duct Stones : A Systematic Review and Meta-Analysis
Joint Authors
Madhoun, Mohammad F.
Tierney, William M.
Wani, Sachin
Maple, John T.
Hong, Sam
Source
Diagnostic and Therapeutic Endoscopy
Issue
Vol. 2014, Issue 2014 (31 Dec. 2014), pp.1-8, 8 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2014-03-06
Country of Publication
Egypt
No. of Pages
8
Main Subjects
Abstract EN
Background.
Removal of large stones can be challenging and frequently requires the use of mechanical lithotripsy (ML).
Endoscopic papillary large balloon dilation (EPLBD) following endoscopic sphincterotomy (ES) is a technique that appears to be safe and effective.
However, data comparing ES + EPLBD with ES alone have not conclusively shown superiority of either technique.
Objective.
To assess comparative efficacies and rate of adverse events of these methods.
Method.
Studies were identified by searching nine medical databases for reports published between 1994 and 2013, using a reproducible search strategy.
Only studies comparing ES and ES + EPLBD with regard to large bile duct stone extraction were included.
Pooling was conducted by both fixed-effects and random-effects models.
Risk ratio (RR) estimates with 95% confidence interval (CI) were calculated.
Results.
Seven studies (involving 902 patients) met the inclusion criteria; 3 of 7 studies were prospective trials.
Of the 902 patients, 463 were in the ES + EPLBD group, whereas 439 underwent ES alone.
There were no differences noted between the groups with regard to overall stone clearance (98% versus 95%, RR = 1.01 [0.97, 1.05]; P =0.60) and stone clearance at the 1st session (87% versus 79%, RR = 1.11 [0.98, 1.25]; P =0.11).
ES + EPLBD was associated with a reduced need for ML compared to ES alone (15% versus 32%; RR = 0.49 [0.32, 0.74]; P = 0.0008) and was also associated with a reduction in the overall rate of adverse events (11% versus 18%; RR = 0.58 [0.41, 0.81]; P =0.001).
Conclusions.
ES + EPLBD has similar efficacy to ES alone while significantly reducing the need for ML.
Further, ES + EPLBD appears to be safe, with a lower rate of adverse events than traditional ES.
ES + EPLBD should be considered as a first-line technique in the management of large bile duct stones.
American Psychological Association (APA)
Madhoun, Mohammad F.& Wani, Sachin& Hong, Sam& Tierney, William M.& Maple, John T.. 2014. Endoscopic Papillary Large Balloon Dilation Reduces the Need for Mechanical Lithotripsy in Patients with Large Bile Duct Stones : A Systematic Review and Meta-Analysis. Diagnostic and Therapeutic Endoscopy،Vol. 2014, no. 2014, pp.1-8.
https://search.emarefa.net/detail/BIM-462393
Modern Language Association (MLA)
Madhoun, Mohammad F.…[et al.]. Endoscopic Papillary Large Balloon Dilation Reduces the Need for Mechanical Lithotripsy in Patients with Large Bile Duct Stones : A Systematic Review and Meta-Analysis. Diagnostic and Therapeutic Endoscopy No. 2014 (2014), pp.1-8.
https://search.emarefa.net/detail/BIM-462393
American Medical Association (AMA)
Madhoun, Mohammad F.& Wani, Sachin& Hong, Sam& Tierney, William M.& Maple, John T.. Endoscopic Papillary Large Balloon Dilation Reduces the Need for Mechanical Lithotripsy in Patients with Large Bile Duct Stones : A Systematic Review and Meta-Analysis. Diagnostic and Therapeutic Endoscopy. 2014. Vol. 2014, no. 2014, pp.1-8.
https://search.emarefa.net/detail/BIM-462393
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-462393