Endoscopic papillary large balloon dilation vs endoscopic sphincterotomy for retrieval of common bile duct stones:A meta-analysis

作     者：Piao-Piao Jin Jian-Feng Cheng Dan Liu Mei Mei Zhao-Qi Xu Lei-Min Sun 

作者机构：Department of GastroenterologySir Run Run Shaw HospitalSchool of MedicineZhejiang University Internal MedicineDivision of GastroenterologyCarolinas Medical CenterCharlotteNC 28203United States Department of StatisticsTexas A and M UniversityCollege StationTX 77843United States Doppler Ultrasonic DepartmentThe Second Affiliated Hospital of Zhejiang University School of Medicine Fifth People’s Hospital of Yuhang District 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2014年第20卷第18期

页      面：5548-5556页

核心收录：

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] 

基　　金：Supported by Technology Foundation for Selected Overseas Chinese Scholar Zhejiang Province No.188020-710903/016 

主　　题：Endoscopic papillary large balloon dilation Endosc 

摘      要：AIM:To compare the efficacy and safety of endoscopic papillary large balloon dilation(EPLBD)with endoscopic sphincterotomy(EST)in retrieval of common bile duct stones(≥10 mm).METHODS:PubMed,Web of Knowledge,EBSCO,the Cochrane Library,and EMBASE were searched for eligible *** controlled trials(RCTs)that compared EPLBD with EST were *** extraction and quality assessment were performed by two independent reviewers using the same *** disagreement was discussed with a third reviewer until a final consensus was *** outcomes of complete bile duct stone clearance,stone clearance in one session,requirement for mechanical lithotripsy,and overall complication rate were determined using relative risk and 95%*** separate post-endoscopic retrograde cholangiopancreatography complications were pooled and determined with the Peto odds ratio and95%CI because of the small number of *** was evaluated with the chi-squared test with P≤0.1 and I2 with a cutoff of≥50%.A fixed effects model was used primarily.A random effects model was applied when significant heterogeneity was *** analysis was applied to explore the potential ***:Five randomized controlled trials with 621participants were *** compared with EST had similar outcomes with regard to complete stone removal rate(93.7%vs 92.5%,P=0.54)and complete duct clearance in one session(82.2%vs 77.7%,P=0.17).Mechanical lithotripsy was performed less in EPLBD in the retrieval of whole stones(15.5%vs25.2%,P=0.003),as well as in the stratified subgroup of stones larger than 15 mm(24.2%vs 40%,P=0.001).There was no statistically significant difference in the incidence of overall adverse events(7.9%vs 10.7%,P=0.25),post-ERCP pancreatitis(4.0%vs 5.0%,P=0.54),hemorrhage(1.7%vs 2.8%,P=0.32),perforation(0.3%vs 0.9%,P=0.35)or acute cholangitis(1.3%vs 1.3%,P=0.92).CONCLUSION:EPLBD could be advocated as an alternative to EST in the retrieval of large