Impact of guidewire caliber on ERCP outcomes: Systematic review and meta-analysis comparing 0.025- and 0.035-inch guidewires
Background and study aims 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 availabl...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Georg Thieme Verlag KG
2022-07-01
|
| Series: | Endoscopy International Open |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/a-1834-7101 |
| _version_ | 1811342312062582784 |
|---|---|
| author | Muhammad Aziz Amna Iqbal Zohaib Ahmed Saad Saleem Wade Lee-Smith Hemant Goyal Faisal Kamal Yaseen Alastal Ali Nawras Douglas G. Adler |
| author_facet | Muhammad Aziz Amna Iqbal Zohaib Ahmed Saad Saleem Wade Lee-Smith Hemant Goyal Faisal Kamal Yaseen Alastal Ali Nawras Douglas G. Adler |
| author_sort | Muhammad Aziz |
| collection | DOAJ |
| description | Background and study aims 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.
Patients and methods 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 P values were generated. P < 0.05 was considered significant.
Results 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, P = 0.60). The overall rates of PEP were also similar between the two groups (RR: 1.15, CI: 0.73–1.81, P = 0.56). Other outcomes (overall cannulation rate, cholangitis, perforation, bleeding, use of adjunct techniques) were also comparable.
Conclusions 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. |
| first_indexed | 2024-04-13T19:09:20Z |
| format | Article |
| id | doaj.art-858cf7ef2b3e4d1caf33fdd7328645d2 |
| institution | Directory Open Access Journal |
| issn | 2364-3722 2196-9736 |
| language | English |
| last_indexed | 2024-04-13T19:09:20Z |
| publishDate | 2022-07-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Endoscopy International Open |
| spelling | doaj.art-858cf7ef2b3e4d1caf33fdd7328645d22022-12-22T02:33:53ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-97362022-07-011007E990E99710.1055/a-1834-7101Impact of guidewire caliber on ERCP outcomes: Systematic review and meta-analysis comparing 0.025- and 0.035-inch guidewiresMuhammad Aziz0Amna Iqbal1Zohaib Ahmed2Saad Saleem3Wade Lee-Smith4Hemant Goyal5Faisal Kamal6Yaseen Alastal7Ali Nawras8Douglas G. Adler9Division of Gastroenterology and Hepatology, University of Toledo, Toledo, Ohio, United StatesDepartment of Internal Medicine, University of Toledo, Toledo, Ohio, United StatesDepartment of Internal Medicine, University of Toledo, Toledo, Ohio, United StatesDepartment of Internal Medicine, Sunrise Hospital and Medical center, Las Vegas, Nevada, United StatesUniversity of Toledo Libraries, University of Toledo, Toledo, Ohio, United StatesThe Wright Center for Graduate Medical Education, Scranton, Pennsylvania, United StatesDivision of Gastroenterology, University of California San Francisco, San Francisco, California, United StatesDivision of Gastroenterology and Hepatology, University of Toledo, Toledo, Ohio, United StatesDivision of Gastroenterology and Hepatology, University of Toledo, Toledo, Ohio, United StatesCenter for Advanced Therapeutic Endoscopy (CATE), Porter Adventist Hospital/PEAK Gastroenterology, Denver, Colorado, United StatesBackground and study aims 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. Patients and methods 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 P values were generated. P < 0.05 was considered significant. Results 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, P = 0.60). The overall rates of PEP were also similar between the two groups (RR: 1.15, CI: 0.73–1.81, P = 0.56). Other outcomes (overall cannulation rate, cholangitis, perforation, bleeding, use of adjunct techniques) were also comparable. Conclusions 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.http://www.thieme-connect.de/DOI/DOI?10.1055/a-1834-7101 |
| spellingShingle | Muhammad Aziz Amna Iqbal Zohaib Ahmed Saad Saleem Wade Lee-Smith Hemant Goyal Faisal Kamal Yaseen Alastal Ali Nawras Douglas G. Adler Impact of guidewire caliber on ERCP outcomes: Systematic review and meta-analysis comparing 0.025- and 0.035-inch guidewires Endoscopy International Open |
| title | Impact of guidewire caliber on ERCP outcomes: Systematic review and meta-analysis comparing 0.025- and 0.035-inch guidewires |
| title_full | Impact of guidewire caliber on ERCP outcomes: Systematic review and meta-analysis comparing 0.025- and 0.035-inch guidewires |
| title_fullStr | Impact of guidewire caliber on ERCP outcomes: Systematic review and meta-analysis comparing 0.025- and 0.035-inch guidewires |
| title_full_unstemmed | Impact of guidewire caliber on ERCP outcomes: Systematic review and meta-analysis comparing 0.025- and 0.035-inch guidewires |
| title_short | Impact of guidewire caliber on ERCP outcomes: Systematic review and meta-analysis comparing 0.025- and 0.035-inch guidewires |
| title_sort | impact of guidewire caliber on ercp outcomes systematic review and meta analysis comparing 0 025 and 0 035 inch guidewires |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/a-1834-7101 |
| work_keys_str_mv | AT muhammadaziz impactofguidewirecaliberonercpoutcomessystematicreviewandmetaanalysiscomparing0025and0035inchguidewires AT amnaiqbal impactofguidewirecaliberonercpoutcomessystematicreviewandmetaanalysiscomparing0025and0035inchguidewires AT zohaibahmed impactofguidewirecaliberonercpoutcomessystematicreviewandmetaanalysiscomparing0025and0035inchguidewires AT saadsaleem impactofguidewirecaliberonercpoutcomessystematicreviewandmetaanalysiscomparing0025and0035inchguidewires AT wadeleesmith impactofguidewirecaliberonercpoutcomessystematicreviewandmetaanalysiscomparing0025and0035inchguidewires AT hemantgoyal impactofguidewirecaliberonercpoutcomessystematicreviewandmetaanalysiscomparing0025and0035inchguidewires AT faisalkamal impactofguidewirecaliberonercpoutcomessystematicreviewandmetaanalysiscomparing0025and0035inchguidewires AT yaseenalastal impactofguidewirecaliberonercpoutcomessystematicreviewandmetaanalysiscomparing0025and0035inchguidewires AT alinawras impactofguidewirecaliberonercpoutcomessystematicreviewandmetaanalysiscomparing0025and0035inchguidewires AT douglasgadler impactofguidewirecaliberonercpoutcomessystematicreviewandmetaanalysiscomparing0025and0035inchguidewires |