Efficacy and safety of endoscopic transpapillary gallbladder drainage in acute cholecystitis:An updated meta-analysis

作     者：David M Jandura Srinivas R Puli 

作者机构：Department of GastroenterologyUniversity of Illinois College of Medicine at PeoriaPeoriaIL 61637United States Department of Gastroenterology and HepatologyUniversity of Illinois College of Medicine at PeoriaPeoriaIL 61637United States 

出 版 物：《World Journal of Gastrointestinal Endoscopy》 (世界胃肠内镜杂志（英文版）（电子版）)

年 卷 期：2021年第13卷第8期

页      面：345-355页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Endoscopic transpapillary gallbladder drainage Acute cholecystitis Inoperable treatment Double pigtail stent Nasobiliary drainage 

摘      要：BACKGROUND Percutaneous transhepatic gallbladder drainage has been the most frequently performed treatment for acute cholecystitis for patients who are not candidates for *** transpapillary gallbladder drainage(ETGBD)has evolved into an alternative *** have been numerous retrospective and prospective studies evaluating ETGBD for acute cholecystitis,though results have been *** To evaluate the efficacy and safety of ETGBD in the treatment of inoperable patients with acute *** We performed a systematic review of major literature databases including PubMed,OVID,Science Direct,Google Scholar(from inception to March 2021)to identify studies reporting technical and clinical success,and post procedure adverse events in *** pooled rates were then calculated using fixed effects models for technical and clinical success,and post procedure adverse events,including recurrent *** We found 21 relevant articles that were then included in the *** all 1307 patients were *** pooled technical success rate was 82.62%[95%confidence interval(CI):80.63-84.52].The pooled clinical success rate was found to be 94.87%(95%CI:93.54-96.05).The pooled overall complication rate was 8.83%(95%CI:7.42-10.34).Pooled rates of post procedure adverse events were bleeding 1.03%(95%CI:0.58-1.62),perforation 0.78%(95%CI:0.39-1.29),peritonitis/bile leak 0.45%(95%CI:0.17-0.87),and pancreatitis 1.98%(95%CI:1.33-2.76).The pooled rates of stent occlusion and migration were 0.39%(95%CI:0.13-0.78)and 1.3%(95%CI:0.75-1.99)*** pooled rate of cholecystitis recurrence following ETGBD was 1.48%(95%CI:0.92-2.16).CONCLUSION Our meta-analysis suggests that ETGBD is a feasible and efficacious treatment for inoperable patients with acute cholecystitis.