Biliary sphincterotomy alone vs biliary stent with or without biliary sphincterotomy for the management of post-cholecystectomy bile leak: a sytematic review and meta-analysis

BACKGROUND: Endoscopic therapy with ERCP is considered the first line treatment in the management of post-cholecystectomy bile leak (PCBL). Currently there is no consensus on the most effective endoscopic intervention for PCBL. Hence, we performed a systematic review and meta-analysis to compare the effectiveness and safety of the two interventional groups (biliary sphincterotomy [BS] alone vs biliary stent ± BS) in management of PCBL. METHODS: We conducted a comprehensive search of multiple electronic databases and conference proceedings (from inception through January 2021). The primary outcome was to compare the pooled rate of clinical success between the 2 groups. The secondary outcome was to es timate the pooled rate of adverse events. RESULTS: The pooled rate of clinical success with BS alone (5 studies, 299 patients) was 88% (95% CI: 84%- 92%, I2: 0%) and for biliary stent ± BS (5 studies, 864 patients) was 97% (CI: 93%-100%, I2: 79%). The rate of clinical success in biliary stent ± BS group was significantly higher than BS alone group (OR: 3.91 95% CI: 2.29-6.69, p
Source: Digestive Diseases - Category: Gastroenterology Source Type: research