Evidence map›Paper›PMID 42869974›Full record

ArticleSurgical endoscopy2026

Initial non-surgical versus upfront surgical management of ERCP-related perforations by Stapfer type: a systematic review and meta-analysis.

Eyad Jamileh, Omar Farooq, Mohamed Xamza, Daren Subar, Joel Lambert

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Article 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
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0citing papers in PubMed
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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

5 authors.

Eyad Jamileh *School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland, UK. ejamileh@hotmail.com.ORCID http://orcid.org/0000-0002-1006-9824
Omar Farooq *Department of General Surgery, East Lancashire Hospitals NHS Trust, Blackburn, England, UK.
Mohamed XamzaDepartment of General Surgery, Barking, Havering and Redbridge University Hospitals NHS Trust, London, England, UK.
Daren SubarDepartment of General Surgery, East Lancashire Hospitals NHS Trust, Blackburn, England, UK.
Joel LambertDepartment of General Surgery, East Lancashire Hospitals NHS Trust, Blackburn, England, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundERCP-related perforation is uncommon but potentially fatal, and optimal initial management remains uncertain across Stapfer subtypes. We compared initial non-surgical management with upfront surgery overall and by Stapfer type, retaining patients requiring rescue surgery within their original strategy.

methodsDatabases were searched to 30 June 2026. Treatment success was standardised as survival to discharge without operative rescue after initial non-surgical management and survival to discharge after upfront surgery. Random-effects risk ratios (RRs) were pooled overall and by Stapfer type; certainty was assessed using GRADE.

resultsTwenty-three retrospective studies included 681 perforations. In 15 reconstructable cohorts, initial-strategy success was 227/273 (83.2%) after initial non-surgical management and 75/89 (84.3%) after upfront surgery (RR 0.97, 95% CI 0.81-1.17; I

conclusionVery-low-certainty evidence suggests management should be tailored to Stapfer subtype, physiological stability and source control, with prompt operative rescue when non-surgical management fails.

Indexed as

Endoscopic retrograde cholangiopancreatographyOutcomesPerforationsSurgical managementSystematic review

Identifiers

PMID42869974

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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.