Evidence map›Paper›PMID 40899240›Full record

ArticleClinical endoscopy2025

Comparative efficacy and safety of supine versus prone positioning in endoscopic retrograde cholangiopancreatography: a systematic review and meta-analysis.

Fariha Hasan, Muhammad Shahzil, Ayesha Liaquat, Taha Bin Arif, Muhammad Yafaa Naveed Chaudhary, Eugene Annor, Dushyant Singh Dahiya, Jay Patel, Rohini Maddigunta, Avneet Singh and 4 more

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Article in Clinical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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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.

2 · The registry

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3 · Its place in the literature

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No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

14 authors.

Fariha HasanDepartment of Internal Medicine, Cooper University Hospital, Camden, NJ, USA.
Muhammad ShahzilPenn State Health, Milton S. Hershey Medical Center, Hershey, PA, USA.
Ayesha LiaquatDepartment of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Taha Bin ArifDepartment of Internal Medicine, Sinai Hospital Baltimore, Baltimore, MD, USA.
Muhammad Yafaa Naveed ChaudharyDepartment of Internal Medicine, Indiana University Southwest, New Albany, IN, USA.
Eugene AnnorDepartment of Internet Medicine, University of Illinois College of Medicine, Chicago, IL, USA.
Dushyant Singh DahiyaDepartment of Gastroenterology & Hepatology, The University of Kansas School of Medicine, Kansas City, KS, USA.
Jay PatelDepartment of Gastroenterology, Cooper University Hospital, Camden, NJ, USA.
Rohini MaddiguntaCooper Medical School of Rowan University, Camden, NJ, USA.
Avneet SinghDepartment of Internal Medicine, Cooper University Hospital, Camden, NJ, USA.
Alexander GarciaDepartment of Internal Medicine, Cooper University Hospital, Camden, NJ, USA.
Babu P MohanOrlando Gastroenterology PA, Orlando, FL, USA.
Rachel FrankDepartment of Gastroenterology, Cooper University Hospital, Camden, NJ, USA.
Adib ChaayaDepartment of Gastroenterology, Cooper University Hospital, Camden, NJ, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEndoscopic retrograde cholangiopancreatography (ERCP) is conventionally performed in the prone position (PP). Recent studies have shown that the supine position (SP) is an effective alternative, with comparable success rates. We conducted a meta-analysis to directly compare the safety and efficacy of the two ERCP positions.

methodsIn line with Cochrane and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic review was performed through a comprehensive search of PubMed, Embase, Web of Science, and the Cochrane Library. Statistical analyses were performed using RevMan, with results considered significant at p<0.05 and reported as odds ratios (ORs) and mean differences (MDs).

resultsEleven studies (24,285 patients) were included in the final analysis. Procedural success was significantly higher in the PP (OR, 0.52; 95% confidence interval [CI], 0.36-0.75; p<0.0004) than the SP. However, no significant difference was observed in procedure times (MD, 0.22; 95% CI, -7.07 to 7.50; p=0.95), number of cardiopulmonary complications (OR, 1.08; 95% CI, 0.47-2.48; p=0.86), or post-ERCP pancreatitis (OR, 1.12; 95% CI, 0.52-2.42; p=0.31) between the two groups.

conclusionsThe PP demonstrates superior ERCP success compared to the SP, without prolonging procedure time or increasing the risk of adverse events. However, given the comparable procedure times, incidence of adverse events, and increased comfort for both patients and anesthesiologists, the SP may be a suitable alternative for a select group of patients in whom the PP is not feasible, such as those with morbid obesity or recent abdominal surgery.

Indexed as

Endoscopic retrograde cholangiopancreatographyMeta-analysisPancreatitisProne positionSupine positionTherapeutic outcome

Identifiers

PMID40899240
PMCPMC12936919

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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.