SynthesisGastrointestinal endoscopy2025
Systematic review of technical factors associated with persistent fistula after EUS-directed transgastric ERCP in patients with Roux-en-Y gastric bypass.
Synthesis in Gastrointestinal endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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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.
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.
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Who cites it
3 citing papers in PubMed.
- Weight matters: long-term evaluation of weight regain and fistula recurrence post endoscopic ultrasound-directed transgastric ERCP (EDGE).Surgical endoscopy · 2026Article
- Endoscopic ultrasound-guided gastroenterostomy with lumen-apposing metal stent: an animal study comparison of wireless and over-the-wire techniques.Scientific reports · 2025Article
- Endoscopic Ultrasound-Directed Transgastric Endoscopic Retrograde Cholangiopancreatography (EDGE): Techniques, Outcomes and Safety Profiles.Journal of clinical medicine · 2025Review
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
BACKGROUND AND
aimsAn important unintended consequence of EUS-directed transgastric ERCP (EDGE) in patients with Roux-en-Y gastric bypass is persistent fistula (PF) formation after stent removal. To better inform procedural decision-making, we wanted to elucidate the technical factors associated with PF after EDGE.
methodsWe performed a systematic literature search of EMBASE, Scopus, and PubMed databases from inception until November 2024. Two authors independently extracted data on technical factors potentially associated with PF. Discrepancies were resolved by consensus. The association between PF and selected technical characteristics was evaluated.
resultsOf 398 patients who underwent objective testing after EDGE, 78 (19.6%) had PF. There did not appear to be an association between PF and location of the fistula (gastrogastric vs jejunogastric) (relative risk, 1.16; 95% CI, 0.93-1.41; P = .14) or whether ERCP was performed at the time of fistula creation or later (relative risk, 1.03; 95% CI, 0.66-1.70; P = .99). The use of a larger lumen-apposing metal stent (20 mm vs 15 mm) did appear to be associated with PF (relative risk, 1.65; 95% CI, 1.02-2.72; P = .022). Passive (spontaneous) fistula closure after stent removal was also associated with PF formation relative to active closure (relative risk, 7.25; 95% CI, 1.08-192.5; P = .020). The association between stent dwell time and PF was not statistically significant according to the Wilcoxon signed rank sum test (P = .13) but was significant by the weighted paired t test (P = .04).
conclusionsIn this systematic review, larger stent size, passive (spontaneous) closure after stent removal, and longer stent dwell time appeared to be associated with an increased risk of PF formation after EDGE.
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Registered trials
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