Evidence map›Paper›PMID 39702566›Full record

SynthesisSurgical endoscopy2025

Fully covered self-expandable metal stents versus multiple plastic stents for the treatment of post-orthotopic liver transplant anastomotic biliary strictures: An updated systematic review and meta-analysis of randomized controlled trials.

Stefano Baraldo, Gilmara Coelho Meine, Paula Arruda Espirito Santo, Eduardo Cerchi Barbosa, Angélica Luciana Nau, Margaret G Keane, Radhika Chavan, Yu-Ting Kuo, Dario Ligresti

Erratum issuedAbstract readSystematic ReviewMeta-AnalysisComparative Study
PubMed Publisher
In one paragraph

Synthesis in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Stefano BaraldoDepartment of Endoscopy, Barretos Cancer Hospital, R. Antenor Duarte Vilela, 1331 - Dr. Paulo Prata, Barretos, Sao Paulo, 14784 400, Brazil. stefanobps@me.com.ORCID http://orcid.org/0000-0002-6359-9167
Gilmara Coelho MeineDivision of Gastroenterology, Department of Internal Medicine, Feevale University, Novo Hamburgo, Brazil.
Paula Arruda Espirito SantoDiagnostic Imaging and Specialized Diagnosis Unit, University Hospital of Federal University of Sao Carlos, Sao Carlos, Brazil.
Eduardo Cerchi BarbosaEvangelical University of Goias, Anapolis, Brazil.
Angélica Luciana NauDepartment of Pediatric Gastroenterology, Jaraguá Hospital, Jaraguá do Sul, Brazil.
Margaret G KeaneDepartment of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, MD, USA.
Radhika ChavanDepartment of Gastroenterology and Advanced Endoscopy, Ansh Clinic, Ahmedabad, Gujarat, India.
Yu-Ting KuoDivision of Endoscopy, Department of Integrated Diagnostics & Therapeutics, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan.
Dario LigrestiEndoscopy Service, Department of Diagnostic and Therapeutic Services, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Palermo, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsThe most common adverse event (AE) of orthotopic liver transplantation (OLT) is anastomotic biliary stricture (ABS). Management varies widely between centers, and it is not clear whether a combination of endoscopic dilation of the stenosis followed by multiple plastic stents (MPS) or placement of a fully covered self-expandable metal stent (fcSEMS) is better for the management of post-OLT ABS. This systematic review and meta-analysis aimed to compare the efficacy, safety, and cost of fcSEMS versus MPS in the treatment of post-OLT ABS.

methodsWe searched PubMed, Cochrane, and Embase databases for randomized controlled trials (RCTs) comparing fcSEMS with MPS for the treatment of patients with post-OLT ABS and reporting at least one of the outcomes of interest. The pooled estimates were calculated using the random-effects model, and I

resultsThe study included 5 RCTs (245 patients). There was no statistically significant difference between fcSEMS and MPS in stricture resolution (RR 0.99; 95% CI 0.88 to 1.11; p = 0.86), stricture recurrence (RR 2.22; 95% CI 0.73 to 6.75; p = 0.16), treatment cost (MD - 5.31 thousand dollars 95% CI -12.76 to 2.13; p = 0.16), and AEs (RR 0.87; 95% CI 0.27 to 2.83; p = 0.82). However, fcSEMS reduced the number of ERCP sessions (MD - 1.7 sessions; CI 95% - 2.9 to - 0.5; p = 0.005) and treatment duration (MD-95.7 days; 95% CI -184.5 to -6.9; p = 0.03) compared with MPS.

conclusionfcSEMS and MPS had similar efficacy and safety in patients with ABS post-OLT. However, fcSEMS was associated with fewer ERCP sessions and shorter treatment duration.

Indexed as

CholestasisLiver TransplantationPostoperative ComplicationsSelf Expandable Metallic StentsStentsAnastomosis, SurgicalCholangiopancreatography, Endoscopic RetrogradeConstriction, PathologicHumansPlasticsRandomized Controlled Trials as TopicTreatment OutcomePlasticsAnastomotic biliary strictureERCPfcSEMSMPSPost-orthotopic liver transplant

Identifiers

PMID39702566

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.