ERCP-guided cholangioscopy using a single-use system: nationwide register-based study of its use in clinical practice

Lubbe, Jeanne; Arnelo, Urban; Lundell, Lars; Swahn, Fredrik; Törnqvist, Björn; Jonas, Eduard; Löhr, Matthias; Enochsson, Lars

doi:10.1055/s-0034-1391990

Cited by 14 publications

(16 citation statements)

References 17 publications

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“…With regard to the adverse events of single‐operator cholangioscopy‐guided biopsy, a single centre prospective study with literature review of 646 patients reported an overall procedure‐related adverse events of 9.4%‐21.4% . Another large cohort study showed that the SpyGlass procedure (408 patients) was associated with a higher rate of intraprocedure adverse events (OR 3.01, 95%CI 1.52‐5.36) than conventional ERCP procedures (35 944 patients), and the rate of post‐procedure adverse events was higher in the early study period than in the late study period (25.3% vs 15.6%, P = 0.017), which highlights the importance of personnel training in reducing single‐operator cholangioscopy‐related adverse events . The rate of adverse events of diagnostic direct peroral cholangioscopy can be as high as 10% …”

Section: Resultsmentioning

confidence: 99%

Review article: Asia‐Pacific consensus recommendations on endoscopic tissue acquisition for biliary strictures

Sun¹,

Lee

Cai

et al. 2018

Aliment Pharmacol Ther

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Section: Resultsmentioning

confidence: 99%

Review article: Asia‐Pacific consensus recommendations on endoscopic tissue acquisition for biliary strictures

Sun¹,

Lee

Cai

et al. 2018

Aliment Pharmacol Ther

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“…Although the incidence rate of adverse events appears low (6.1%) in our analysis, some studies reported high complication rates of treatment with SOPOC. Lubbe et al . reported that SOPOC was associated with post‐procedural adverse events in 19.1% of patients.…”

Section: Discussionmentioning

confidence: 99%

“…Although the incidence rate of adverse events appears low (6.1%) in our analysis, some studies reported high complication rates of treatment with SOPOC. Lubbe et al 40 reported that SOPOC was associated with post-procedural adverse events in 19.1% of patients. Tieu et al 21 and Sethi et al 41 reported that the adverse event rate of ERCP combined with SOPOC was twofold higher than that of ERCP alone.…”

Section: Discussionmentioning

confidence: 99%

Single‐operator peroral cholangioscope in treating difficult biliary stones: A systematic review and meta‐analysis

Zheng

Wei

Tang

et al. 2018

Digestive Endoscopy

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Background and Aim Current evidence supporting the utility of single‐operator peroral cholangioscope (SOPOC) in the management of difficult bile duct stones is limited. We conducted the present systematic review and meta‐analysis to evaluate the efficacy and safety of SOPOC in treating difficult bile duct stones. Methods We searched studies up to April 2018, using MEDLINE, EMBASE, the Cochrane Library, and Google Scholar. Quality assessment of the studies was completed with the Newcastle‐Ottawa Scale. Main outcomes were complete stone clearance rate, single‐session stone clearance rate, number of endoscopic sessions needed for stone clearance, and adverse events. We calculated the pooled estimates with random‐effects models. Potential publication bias was assessed. Results Twenty‐four studies involving 2786 patients met the inclusion criteria. Pooled proportion of patients with complete stone clearance was 94.3% (95% confidence interval [95% CI]: 90.2–97.5%). Single‐session stone clearance was achieved in 71.1% (95% CI: 62.1–79.5%) of the pooled patients. Pooled number of sessions needed for stone clearance was 1.26 (95% CI: 1.17–1.34%). Pooled adverse event rate was 6.1% (95% CI: 3.8–8.7%). Potential publication bias was detected but had no significant influence on the results. Conclusions Single‐operator peroral cholangioscope is an effective and safe treatment for difficult bile duct stones when conventional methods have failed. More randomized controlled trials are warranted to confirm the results.

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“…As such, there is a component of selection bias when patients are chosen to undergo POC. A recent study 60 , completed in Sweden based on a national registry, reported that the risk for intra- and post-procedural adverse events is significantly increased when a patient undergoes POC in conjunction with ERCP, as opposed to ERCP alone. However, the study also noted that in a multivariate analysis that adjusted for confounders, the risk for pancreatitis and cholangitis was not increased.…”

Section: Discussionmentioning

confidence: 99%

The efficacy of peroral cholangioscopy for difficult bile duct stones and indeterminate strictures: a systematic review and meta-analysis

et al. 2016

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Background and study aims: Current evidence supporting the efficacy of peroral cholangioscopy (POC) in the evaluation and management of difficult bile duct stones and indeterminate strictures is limited. The aims of this systematic review and meta-analysis were to assess the following: the efficacy of POC for the therapy of difficult bile duct stones, the diagnostic accuracy of POC for the evaluation of indeterminate biliary strictures, and the overall adverse event rates for POC. Patients and methods: Patients referred for the removal of difficult bile duct stones or the evaluation of indeterminate strictures via POC were included. Search terms pertaining to cholangioscopy were used, and articles were selected based on preset inclusion and exclusion criteria. Quality assessment of the studies was completed with a modified Newcastle-Ottawa Scale. After critical literature review, relevant outcomes of interest were analyzed. Meta-regression was performed to examine potential sources of between-study variation. Publication bias was assessed via funnel plots and Egger’s test. Results: A total of 49 studies were included. The overall estimated stone clearance rate was 88 % (95 % confidence interval [95 %CI] 85 % – 91 %). The accuracy of POC was 89 % (95 %CI 84 % – 93 %) for making a visual diagnosis and and 79 % (95 %CI 74 % – 84 %) for making a histological diagnosis. The estimated overall adverse event rate was 7 % (95 %CI 6 % – 9 %). Conclusions: POC is a safe and effective adjunctive tool with endoscopic retrograde cholangiopancreatography (ERCP) for the evaluation of bile duct strictures and the treatment of bile duct stones when conventional methods have failed. Prospective, controlled clinical trials are needed to further elucidate the precise role of POC during ERCP.

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ERCP-guided cholangioscopy using a single-use system: nationwide register-based study of its use in clinical practice

Cited by 14 publications

References 17 publications

Review article: Asia‐Pacific consensus recommendations on endoscopic tissue acquisition for biliary strictures

Review article: Asia‐Pacific consensus recommendations on endoscopic tissue acquisition for biliary strictures

Single‐operator peroral cholangioscope in treating difficult biliary stones: A systematic review and meta‐analysis

The efficacy of peroral cholangioscopy for difficult bile duct stones and indeterminate strictures: a systematic review and meta-analysis

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