PMID- 36381817
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231103
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 14
IP  - 10
DP  - 2022 Oct
TI  - Laparoscopic-Assisted Endoscopic Retrograde Cholangiopancreatography (ERCP) 
      Versus Endoscopic Ultrasound-Directed Transgastric ERCP in Patients With 
      Roux-en-Y Gastric Bypass: A Systematic Review and Meta-Analysis.
PG  - e30196
LID - 10.7759/cureus.30196 [doi]
LID - e30196
AB  - Endoscopic retrograde cholangiopancreatography (ERCP) is a therapeutic procedure 
      for skilled endoscopists that can be even more challenging in some situations, 
      including patients' post-Roux-en-y Gastric Bypass (RYGB) surgery. There is still 
      no consensus on whether laparoscopic-assisted ERCP (LA-ERCP) or endoscopic 
      ultrasound (EUS)-directed transgastric ERCP (EDGE) is the most appropriate, safe, 
      and feasible approach in patients with this type of post-surgical anatomy. This 
      systematic review and meta-analysis aimed to examine both approaches' 
      feasibility, efficacy, and safety in this situation. We searched for electronic 
      databases (MEDLINE, EMBASE, Lilacs, Google Scholar, and Central Cochrane) to 
      identify studies comparing LA-ERCP versus EDGE. Outcomes measured included 
      technical success, adverse events (AEs) and serious AEs, length of stay (LOS), 
      and procedural time. Descriptive data related to the EDGE procedure was also 
      extracted. The risk of bias and the quality of evidence of the enrolled studies 
      were assessed. Five studies, totalizing 268 patients (176 LA-ERCP and 92 EDGE), 
      were included. There was no statistical difference in technical success and AEs 
      between groups; however, the LOS and procedural times were shorter for the EDGE 
      group. High rates of fistula closure and no weight regain were observed in 
      EDGE. Both methods are feasible and safe techniques to perform ERCP in patients 
      with RYGB anatomy, with comparable technical success and adverse events rate. 
      However, EDGE is associated with shorter LOS and procedural time.
CI  - Copyright (c) 2022, de Oliveira et al.
FAU - de Oliveira, Victor L
AU  - de Oliveira VL
AD  - Gastroenterology, Hospital das Clinicas da Universidade de Sao Paulo, Sao Paulo, 
      BRA.
FAU - de Moura, Diogo Turiani H
AU  - de Moura DTH
AD  - Gastroenterology, Hospital das Clinicas da Universidade de Sao Paulo, Sao Paulo, 
      BRA.
FAU - do Monte Junior, Epifanio S
AU  - do Monte Junior ES
AD  - Gastroenterology, Hospital das Clinicas da Universidade de Sao Paulo, Sao Paulo, 
      BRA.
FAU - Proenca, Igor M
AU  - Proenca IM
AD  - Gastroenterology, Hospital das Clinicas da Universidade de Sao Paulo, Sao Paulo, 
      BRA.
FAU - Ribeiro, Igor B
AU  - Ribeiro IB
AD  - Gastroenterology, Hospital das Clinicas da Universidade de Sao Paulo, Sao Paulo, 
      BRA.
FAU - Sanchez-Luna, Sergio A
AU  - Sanchez-Luna SA
AD  - Gastroenterology, University of Alabama at Birmingham Marnix E. Heersink School 
      of Medicine, Birmingham, USA.
FAU - Ribas, Pedro Henrique Boraschi V
AU  - Ribas PHBV
AD  - Gastroenterology, Hospital das Clinicas da Universidade de Sao Paulo, Sao Paulo, 
      BRA.
FAU - Hemerly, Matheus C
AU  - Hemerly MC
AD  - Gastroenterology, Hospital das Clinicas da Universidade de Sao Paulo, Sao Paulo, 
      BRA.
FAU - Bernardo, Wanderley M
AU  - Bernardo WM
AD  - Gastroenterology, Hospital das Clinicas da Universidade de Sao Paulo, Sao Paulo, 
      BRA.
FAU - de Moura, Eduardo Guimaraes H
AU  - de Moura EGH
AD  - Gastroenterology, Hospital das Clinicas da Universidade de Sao Paulo, Sao Paulo, 
      BRA.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20221011
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC9649332
OTO - NOTNLM
OT  - endoscopic retrograde cholangiopancreatography (ercp)
OT  - endoscopic ultrasound (eus)
OT  - endoscopy
OT  - laparoscopy
OT  - roux-en-y gastric bypass (rygb)
OT  - surgery
COIS- The authors have declared financial relationships, which are detailed in the next 
      section.
EDAT- 2022/11/17 06:00
MHDA- 2022/11/17 06:01
PMCR- 2022/10/11
CRDT- 2022/11/16 02:57
PHST- 2022/10/11 00:00 [accepted]
PHST- 2022/11/16 02:57 [entrez]
PHST- 2022/11/17 06:00 [pubmed]
PHST- 2022/11/17 06:01 [medline]
PHST- 2022/10/11 00:00 [pmc-release]
AID - 10.7759/cureus.30196 [doi]
PST - epublish
SO  - Cureus. 2022 Oct 11;14(10):e30196. doi: 10.7759/cureus.30196. eCollection 2022 
      Oct.