Single‐operator Peroral Cholangioscope in Treating Difficult Biliary Stones: A Systematic Review and Meta‐analysis

Abstract

Objectives

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. The 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. The 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. The pooled number of sessions needed for stone clearance was 1.26 (95% CI: 1.17‐1.34). The 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

SOPOC 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.

This article is protected by copyright. All rights reserved.

https://ift.tt/2PSdy3t