Evidence map›Paper›PMID 38555329›Full record

SynthesisDigestive diseases and sciences2024

Comparative Risks of Post-ERCP Adverse Events in Patients with Asymptomatic and Symptomatic Choledocholithiasis: A Systematic Review and Meta-Analysis.

Itegbemie Obaitan, Mouhand F H Mohamed, Azizullah Beran, Michael Rosenheck, Elvis T Obomanu, Tyler M Berzin, Daryl Ramai, Hisham Wehbe, Muhammad Aziz, Neetu Mahendraker and 3 more

Abstract readSystematic ReviewMeta-AnalysisComparative Study
PubMed Publisher
In one paragraph

Synthesis in Digestive diseases and sciences, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
4.6field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 11 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 7 institutions in 1 country.

Itegbemie ObaitanDivision of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN, USA. iobaitan@iu.edu.ORCID http://orcid.org/0000-0001-5002-6821
Mouhand F H MohamedDepartment of Internal Medicine, Warren Alpert Medical School Brown University, Providence, RI, USA.
Azizullah BeranDivision of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN, USA.
Michael RosenheckDepartment of Internal Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
Elvis T ObomanuDepartment of Internal Medicine, Einstein Medical Center, Philadelphia, PA, USA.
Tyler M BerzinCenter for Advanced Endoscopy, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Daryl RamaiDivision of Gastroenterology and Hepatology, University of Utah, Salt Lake City, UT, USA.
Hisham WehbeDivision of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN, USA.
Muhammad AzizDivision of Gastroenterology, Bon Secours Mercy Health, Toledo, OH, USA.
Neetu MahendrakerDepartment of Internal Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
Mohammad Al-HaddadDivision of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN, USA.
Jeffrey J EaslerDivision of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN, USA.
Evan L FogelDivision of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN, USA.
Indiana University School of MedicineBeth Israel Deaconess Medical Center · USBon Secours Mercy Health · USBrown University · USEinstein Medical Center Philadelphia · USIndiana University Health · USUniversity of Utah · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsEndoscopic retrograde cholangiopancreatography (ERCP) is the standard of care for the management of choledocholithiasis but carries risk of complications which may result in significant morbidity and mortality. While currently available guidelines endorse the use of ERCP for the management of symptomatic common bile duct stones, the need for ERCP in incidentally found asymptomatic choledocholithiasis is more controversial, and practice varies on a geographic and institutional level. This systematic review and meta-analysis is conducted to compare post-ERCP adverse events between asymptomatic and symptomatic choledocholithiasis patients.

methodsWe searched PubMed/Embase/Web of Science databases to include all studies comparing post-ERCP outcomes between asymptomatic and symptomatic choledocholithiasis patients. The primary outcome was post-ERCP pancreatitis (PEP), while secondary outcomes included post-ERCP cholangitis, bleeding, and perforation. We calculated pooled risk ratios (RR) and 95% confidence intervals (CIs) using the Mantel-Haenszel method within a random-effect model.

resultsOur analysis included six observational studies, totaling 2,178 choledocholithiasis patients (392 asymptomatic and 1786 symptomatic); 53% were female. Asymptomatic patients exhibited a higher risk of PEP compared with symptomatic patients (11.7% versus 4.8%; RR 2.59, 95% CI 1.56-4.31, p ≤ 0.001). No significant difference was observed in post-ERCP cholangitis, bleeding, or perforation rates between the two groups.

conclusionsAsymptomatic patients with choledocholithiasis appear to have a higher risk of PEP than symptomatic patients, while the risk of other post-ERCP adverse events is similar between the two groups. Interventional endoscopists should thoroughly discuss potential adverse events (particularly PEP) with asymptomatic patients before performing ERCP and utilize PEP-prevention measures more liberally in this subgroup of patients.

Indexed as

Cholangiopancreatography, Endoscopic RetrogradeCholedocholithiasisPancreatitisAsymptomatic DiseasesCholangitisHumansPostoperative ComplicationsRisk FactorsERCPPost-ERCP bleedingPost-ERCP cholangitisPost-ERCP pancreatitis

Identifiers

PMID38555329
OpenAlexW4393336954

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.