Evidence map›Paper›PMID 42680928›Full record

SynthesisSurgical endoscopy2026

Efficacy of double-balloon enteroscopy-endoscopic retrograde cholangiopancreatography for hepaticojejunostomy strictures: a systematic review and meta-analysis.

Huaqi Li, Kareem Khalaf, Yuhong Yuan, Mohamed Bucheeri, Gurmun Brar, Rianne Devloo, Katina Zheng, Malini Hu, Christopher W Teshima, Jeffrey D Mosko and 2 more

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

12 authors.

Huaqi LiDivision of Gastroenterology, St. Michael's Hospital, University of Toronto, 16-046 Cardinal Carter Wing, 30 Bond Street, Toronto, ON, M5B1W8, Canada.
Kareem KhalafDivision of Gastroenterology, St. Michael's Hospital, University of Toronto, 16-046 Cardinal Carter Wing, 30 Bond Street, Toronto, ON, M5B1W8, Canada.ORCID http://orcid.org/0000-0002-5534-7533
Yuhong YuanDivision of Gastroenterology, Department of Medicine, McMaster University, Hamilton, ON, Canada.
Mohamed BucheeriDivision of Gastroenterology, St. Michael's Hospital, University of Toronto, 16-046 Cardinal Carter Wing, 30 Bond Street, Toronto, ON, M5B1W8, Canada.
Gurmun BrarDivision of Gastroenterology, St. Michael's Hospital, University of Toronto, 16-046 Cardinal Carter Wing, 30 Bond Street, Toronto, ON, M5B1W8, Canada.
Rianne DevlooDivision of Gastroenterology, St. Michael's Hospital, University of Toronto, 16-046 Cardinal Carter Wing, 30 Bond Street, Toronto, ON, M5B1W8, Canada.
Katina ZhengDivision of Gastroenterology, St. Michael's Hospital, University of Toronto, 16-046 Cardinal Carter Wing, 30 Bond Street, Toronto, ON, M5B1W8, Canada.
Malini HuDivision of Gastroenterology, St. Michael's Hospital, University of Toronto, 16-046 Cardinal Carter Wing, 30 Bond Street, Toronto, ON, M5B1W8, Canada.
Christopher W TeshimaDivision of Gastroenterology, St. Michael's Hospital, University of Toronto, 16-046 Cardinal Carter Wing, 30 Bond Street, Toronto, ON, M5B1W8, Canada.
Jeffrey D MoskoDivision of Gastroenterology, St. Michael's Hospital, University of Toronto, 16-046 Cardinal Carter Wing, 30 Bond Street, Toronto, ON, M5B1W8, Canada.
Gary R MayDivision of Gastroenterology, St. Michael's Hospital, University of Toronto, 16-046 Cardinal Carter Wing, 30 Bond Street, Toronto, ON, M5B1W8, Canada.
Natalia Causada CaloDivision of Gastroenterology, St. Michael's Hospital, University of Toronto, 16-046 Cardinal Carter Wing, 30 Bond Street, Toronto, ON, M5B1W8, Canada. natalia.calo@unityhealth.to.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsPatients with hepaticojejunostomy anastomotic strictures (HJAS) may be challenging to manage due to altered surgical anatomy, which precludes conventional endoscopic retrograde cholangiopancreatography (ERCP). Double-balloon enteroscopy-assisted ERCP (DBE-ERCP) is a minimally invasive approach for managing HJAS and previous studies have reported variable technical and clinical success rates. This systematic review and meta-analysis aimed to assess overall clinical success, defined as stricture-sustained resolution, and HJAS recurrence following index DBE-ERCP. Additional outcomes included technical success and associated adverse events.

methodsA comprehensive literature search of MEDLINE, Embase, and Cochrane CENTRAL (via Ovid) was conducted from inception to November 2024. The study protocol was registered in the PROSPERO database (CRD42024612553). Eligible studies included randomized controlled trials, non-randomized controlled trials, and observational cohort studies reporting on DBE-ERCP outcomes for HJAS. Pooled estimates for technical and clinical success, recurrence rates, and adverse events were calculated using random-effects models.

resultsSix studies comprising 386 patients met inclusion criteria. Pooled technical success rate of DBE-ERCP was 86% (95% CI 79-92%). Among 346 patients with technically successful procedures, clinical success was achieved in 78% (95% CI 63-88%). Adverse events occurred in 15% of cases among 345 patients (95% CI 5-36%). Five studies reported recurrence rate among 220 patients. Pooled incidence of recurrence was 36% (95% CI 22-52%).

conclusionsDBE-ERCP for the treatment of HJAS is technically successful in close to 90% of cases and appears to lead to stricture resolution in most patients after the first procedure, although long-term outcome data are lacking. In addition, the procedure is associated with an acceptable adverse event profile. Future research should explore long-term outcomes and predictors of procedure outcomes to aid in decision making.

Indexed as

Cholangiopancreatography, Endoscopic RetrogradeDouble-Balloon EnteroscopyJejunostomyJejunumLiverPostoperative ComplicationsAnastomosis, SurgicalConstriction, PathologicHumansTreatment OutcomeAnastomosisCholangiopancreatographyDouble-balloon enteroscopyEndoscopic retrogradeMeta-analysisPancreaticoduodenectomyRoux-en-Y

Identifiers

PMID42680928

What OpenQuestion holds

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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.