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CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(02): E163-E171
DOI: 10.1055/a-1067-4411
Original article
Owner and Copyright © Georg Thieme Verlag KG 2020

EDGE in Roux-en-Y gastric bypass: How does it compare to laparoscopy-assisted and balloon enteroscopy ERCP: a systematic review and meta-analysis

Banreet Singh Dhindsa
1   University of Nevada Las Vegas School of Medicine, Las Vegas, Nevada, United States
,
Amaninder Dhaliwal
2   Division of Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, Nebraska, United States
,
Babu P. Mohan
3   Banner University Medical Center, University of Arizona, Tucson, Arizona, United States
,
Harmeet Singh Mashiana
2   Division of Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, Nebraska, United States
,
Mohit Girotra
4   Division of Gastroenterology and Hepatology, University of Miami Miller School of Medicine, Miami, Florida, United States
,
Shailender Singh
2   Division of Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, Nebraska, United States
,
Gordon Ohning
5   Division of Gastroenterology, University of Nevada Las Vegas School of Medicine, Las Vegas, Nevada, United States
,
Ishfaq Bhat
2   Division of Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, Nebraska, United States
,
Douglas G. Adler
6   Department of Gastroenterology and Hepatology, University of Utah School of Medicine, Salt Lake City, Utah
› Author Affiliations
Further Information

Publication History

submitted 30 July 2019

accepted after revision 15 October 2019

Publication Date:
22 January 2020 (online)

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Abstract

Background and study aims Endoscopic ultrasound-directed transgastric ERCP (EDGE) is a new endoscopic procedure to perform ERCP in Roux-en-y gastric bypass (RYGB) patients. The aim of this study was to conduct a systematic review and meta-analysis to evaluate technical success, clinical success and adverse effects of EDGE and compare it to laparoscopic ERCP (LA-ERCP) and balloon ERCP (BE-ERCP).

Patients and methods We conducted a comprehensive search of several databases and conference proceedings including PubMed, EMBASE, Google-Scholar, LILACS, SCOPUS, and Web of Science databases to identify studies reporting on EDGE, LA-ERCP, and BE-ERCP. The primary outcome was to evaluate technical and clinical success of all three procedures and the secondary analysis focused on calculating the pooled rate of all adverse events (AEs), along with the commonly reported AE subtypes.

Results Twenty-four studies on 1268 patients were included in our analysis with the majority of the population being males with mean age 53.72 years. Pooled rates of technical and clinical success with EDGE wer 95.5 % and 95.9 %, with LA-ERCP were 95.3 % and 92.9 % and were BE-ERCP were 71.4 % and 58.7 %, respectively. Pooled rates of all AEs with EDGE were 21.9 %, with LA-ERCP 17.4 % and with BE-ERCP 8.4 %. Stent migration was the most common AE with EDGE with 13.3 % followed by bleeding with 6.6 %.

Conclusion Our meta-analysis demonstrated that the technical and clinical success of EDGE procedure is better than BE-ERCP and comparable to that of LA-ERCP in RYGB patients. EDGE also has a similar safety profile as compared to LA-ERCP but has higher AE rate as compared to BE-ERCP.

Supplementary material

 

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