PMID- 33043115
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201013
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 8
IP  - 10
DP  - 2020 Oct
TI  - Per-oral pancreatoscopy with intraductal lithotripsy for difficult pancreatic 
      duct stones: a systematic review and meta-analysis.
PG  - E1460-E1470
LID - 10.1055/a-1236-3187 [doi]
AB  - Background and study aims  Per-oral pancreatoscopy (POP) with intraductal 
      lithotripsy via electrohydraulic lithotripsy (EHL) or laser lithotripsy (LL) 
      facilitates optically-guided stone fragmentation of difficult pancreatic stones 
      refractory to conventional endoscopic therapy. The aim of this study was to 
      perform a systematic review and meta-analysis to evaluate the efficacy and safety 
      of POP with intraductal lithotripsy for difficult pancreatic duct stones. 
      Methods  Individualized search strategies were developed in accordance with 
      Preferred Reporting Items for Systematic Reviews and Meta-Analyses and 
      Meta-analysis of Observational Studies in Epidemiology guidelines. This was a 
      cumulative meta-analysis performed by calculating pooled proportions with rates 
      estimated using random effects models. Measured outcomes included pooled 
      technical success, complete or partial stone fragmentation success, complete duct 
      clearance after initial lithotripsy session, and adverse events (AEs). Results  
      Ten studies (n = 302 patients; 67.72 % male; mean age 55.10 +/- 3.22 years) were 
      included with mean stone size of 10.66 +/- 2.19 mm. The most common stone location 
      was in the pancreatic head (66.17 %). Pooled technical success was 91.18 % with 
      an overall fragmentation success of 85.77 %. Single lithotripsy session stone 
      fragmentation and pancreatic duct clearance occurred in 62.05 % of cases. 
      Overall, adverse events were reported in 14.09 % of patients with post-procedure 
      pancreatitis developing in 8.73 %. Of these adverse events, 4.84 % were 
      classified as serious. Comparing POP-EHL vs POP-LL, there was no significant 
      difference in technical success, fragmentation success, single session duct 
      clearance, or AEs ( P  > 0.0500). Conclusions  Based on this systematic review 
      and meta-analysis, POP with intraductal lithotripsy appears to be an effective 
      and relatively safe procedure for patients with difficult to remove pancreatic 
      duct stones.
CI  - The Author(s). This is an open access article published by Thieme under the terms 
      of the Creative Commons Attribution-NonDerivative-NonCommercial License, 
      permitting copying and reproduction so long as the original work is given 
      appropriate credit. Contents may not be used for commecial purposes, or adapted, 
      remixed, transformed or built upon. 
      (https://creativecommons.org/licenses/by-nc-nd/4.0/).
FAU - McCarty, Thomas R
AU  - McCarty TR
AD  - Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's 
      Hospital, Harvard Medical School, Boston, Massachusetts, United States.
FAU - Sobani, Zain
AU  - Sobani Z
AD  - Division of Gastroenterology and Hepatology, University of New Mexico, 
      Albuquerque, New Mexico, United States.
FAU - Rustagi, Tarun
AU  - Rustagi T
AD  - Division of Gastroenterology and Hepatology, University of New Mexico, 
      Albuquerque, New Mexico, United States.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20201007
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC7541182
COIS- Competing interests Dr. Rustagi is a consultant for Boston Scientific and Cook 
      Endoscopy.
EDAT- 2020/10/13 06:00
MHDA- 2020/10/13 06:01
PMCR- 2020/10/01
CRDT- 2020/10/12 05:33
PHST- 2020/04/28 00:00 [received]
PHST- 2020/07/14 00:00 [accepted]
PHST- 2020/10/12 05:33 [entrez]
PHST- 2020/10/13 06:00 [pubmed]
PHST- 2020/10/13 06:01 [medline]
PHST- 2020/10/01 00:00 [pmc-release]
AID - 10.1055/a-1236-3187 [doi]
PST - ppublish
SO  - Endosc Int Open. 2020 Oct;8(10):E1460-E1470. doi: 10.1055/a-1236-3187. Epub 2020 
      Oct 7.