Turkish Journal of Gastroenterology
Review

Does periampullary diverticulum affect ERCP cannulation and post-procedure complications? an up-to-date meta-analysis

1.

The First Clinical Medical School of Lanzhou University, Lanzhou, Gansu, China

2.

Department of Special Minimally Invasive Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu, China; Peilei Mu and Ping Yue contributed equally to this work

3.

Department of Social Medicine and Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China

4.

Department of Special Minimally Invasive Surgery, The First Hospital of Lanzhou University, NO.1 DongGang West Road, LanZhou, China

5.

Hepatopancreatobiliary Surgery Institute of Gansu Province, Clinical Medical College Cancer Center of Lanzhou University, NO.1 DongGang West Road, LanZhou, China

6.

Department of Foreign Languages, Lanzhou University, Lanzhou, China

7.

Department of Special Minimally Invasive Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu, China

8.

Gansu Province Key Laboratory Biotherapy and Regenerative Medicine, Lanzhou, Gansu, China

9.

The Second Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu, China

10.

The Fifth Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu, China

Turk J Gastroenterol 2020; 31: 193-204
DOI: 10.5152/tjg.2020.19058
Read: 2106 Downloads: 810 Published: 20 April 2020

Research conclusions differ on the impact of periampullary diverticulum (PAD) on endoscopic retrograde cholangiopancreatography (ERCP). An up-to-date meta-analysis evaluated the role of PAD in ERCP, especially in terms of cannulation failure and early complications. A comprehensive literature search was performed. All statistical analyses were carried out with the Review Manager 5.3 software. Horizontal lines represented a 95% confidence interval (CI) and the area of each square in forest plots. Twenty-six studies including 23 826 patients with or without PAD who underwent ERCP were evaluated. PAD was associated with an increase in the overall cannulation failure rate (RR=1.46, 95% CI: 1.27-1.67; p<.00001), but in the subgroup of studies performed post-2000, PAD was irrelevant to cannulation failure (RR=1.16, 95% CI: 0.96–1.41; p=0.12). In overall analyses, PAD was also associated with a high risk of ERCP-related pancreatitis (RR=1.32, 95% CI: 1.10-1.59; p=0.003), perforation (RR=1.73, 95% CI: 1.06-2.82; p=0.030), and bleeding (RR=1.48, 95% CI: 1.13–1.93; p=0.005). The presence of PAD increased the overall cannulation failure rate, but not the rate post-2000. PAD also affected the occurrence of early pancreatitis, perforation, and bleeding.

Cite this article as: Mu P, Yue P, Li F, et al. Does periampullary diverticulum affect ERCP cannulation and post-procedure complications? an up-to-date meta-analysis. Turk J Gastroenterol 2020; 31(3): 193-204.

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