AI Article Synopsis

  • The study investigated the effects of two different guidewire sizes (0.035-inch vs. 0.025-inch) on the outcomes of endoscopic retrograde pancreatography (ERCP) through a systematic review and meta-analysis of randomized controlled trials (RCTs).
  • A total of three RCTs involving 1079 patients were analyzed, finding no significant differences in primary biliary cannulation rates or the incidence of pancreatitis among the two guidewire sizes.
  • The conclusion suggests that the choice of guidewire should be based on the endoscopist's skill and preference, rather than on differences in outcomes between the two sizes.

Article Abstract

The impact of guidewire caliber on endoscopic retrograde pancreatography (ERCP) outcomes are not clear. Recent studies have compared two guidewires, 0.035- and 0.025-inch, in randomized controlled trials (RCTs). We performed a systematic review and meta-analysis of available RCTs to assess if different caliber would change the outcomes in ERCP. A systematic search of PubMed/Medline, Embase, Cochrane, SciELO, Global Index Medicus and Web of Science was undertaken through November 23, 2021 to identify relevant RCTs comparing the two guidewires. Binary variables were compared using random effects model and DerSimonian-Laird approach. For each outcome, risk-ratio (RR), 95 % confidence interval (CI), and values were generated.  < 0.05 was considered significant. Three RCTs with 1079 patients (556 in the 0.035-inch group and 523 in the 0.025-inch group) were included. The primary biliary cannulation was similar in both groups (RR: 1.02, CI: 0.96-1.08,  = 0.60). The overall rates of PEP were also similar between the two groups (RR: 1.15, CI: 0.73-1.81,  = 0.56). Other outcomes (overall cannulation rate, cholangitis, perforation, bleeding, use of adjunct techniques) were also comparable. The results of our analysis did not demonstrate a clear benefit of using one guidewire over other. The endoscopist should consider using the guidewire based on his technical skills and convenience.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9286775PMC
http://dx.doi.org/10.1055/a-1834-7101DOI Listing

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