Guide wire-assisted cannulation versus conventional contrast to prevent pancreatitis: A systematic review and meta-analysis based on randomized control trials

Objective: Through this systematic review and meta-analysis, we aim to clarify the differences between these two techniques, thus improving primary success cannulation and reducing complications during endoscopic retrograde cholangiopancreatography, primarily pancreatitis. Methods: A comprehensive s...

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Published inRevista de gastroenterología del Perú Vol. 36; no. 4; pp. 308 - 319
Main Authors De Moura, Eduardo T.H., De Moura, Eduardo G.H., Bernardo, Wanderley, Cheng, Spencer, Kondo, Andre, De Moura, Diogo T.H., Bravo, Jose, Artifon, Everson L.A.
Format Journal Article
LanguagePortuguese
Published Sociedad de Gastroenterología del Perú 01.10.2016
Subjects
GASTROENTEROLOGY & HEPATOLOGY
HEALTH POLICY & SERVICES
MEDICAL ETHICS
MEDICINE, GENERAL & INTERNAL
Metanálisis
Catheterization
Cateterismo
Pancreatitis
Pancreatocolangiografía retrógrada endoscópica
Cholangiopancreatography, endoscopic retrograde
Meta-analysis
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Summary:Objective: Through this systematic review and meta-analysis, we aim to clarify the differences between these two techniques, thus improving primary success cannulation and reducing complications during endoscopic retrograde cholangiopancreatography, primarily pancreatitis. Methods: A comprehensive search was conducted to search for data available up until June2015from the most important databases available in the health field: EMBASE, MEDLINE (via PubMed), Cochrane, LILACS and CENTRAL (via BVS), SCOPUS, the CAPES database (Brazil), and gray literature. Results: Nine randomized clinical trialsincluding2583 people were selected from20,198 studies for meta-analysis. Choledocholithiasis had been diagnosed in mostly (63.8%) of the patients, who were aged an average of 63.15 years. In those patients treated using the guide wire-assisted cannulation technique, provided a significantly lower instance of pancreatitis (RD=0.03; 95% CI: 0.01-0.05; I2= 45%) and greater primary success cannulation (RD=0.07; 95% CI: 0.03-0.12; I2=12%) than conventional contrast cannulation. Conclusions: The guide wire-assisted technique, when compared to the conventional contrast technique, reduces the risk of pancreatitis and increases primary success cannulation rate. Thus, guide wire-assisted cannulation appears to be the most appropriate first-line cannulation technique
ISSN:1022-5129