Cover Image

Stent versus Balloon Dilation for the Treatment of Dominant Strictures in Primary Sclerosing Cholangitis: A Systematic Review and Meta-Analysis

Background/Aims The endoscopic management of primary sclerosing cholangitis (PSC)-associated dominant strictures remains challenging. This systematic review and meta-analysis aimed to compare balloon dilation and stent placement in the treatment of dominant strictures among PSC patients. Methods Lit...

Full description

Saved in:
Bibliographic Details
Main Authors: Marina Tucci Gammaro Baldavira Ferreira (Author), Igor Braga Ribeiro (Author), Diogo Turiani Hourneaux de Moura (Author), Thomas R. McCarty (Author), Alberto Machado da Ponte Neto (Author), Galileu Ferreira Ayala Farias (Author), Antônio Afonso de Miranda Neto (Author), Pedro Victor Aniz Gomes de Oliveira (Author), Wanderley Marques Bernardo (Author), Eduardo Guimarães Hourneaux de Moura (Author)
Format: Book
Published: Korean Society of Gastrointestinal Endoscopy, 2021-11-01T00:00:00Z.
Subjects:
article
Online Access:Connect to this object online.
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background/Aims The endoscopic management of primary sclerosing cholangitis (PSC)-associated dominant strictures remains challenging. This systematic review and meta-analysis aimed to compare balloon dilation and stent placement in the treatment of dominant strictures among PSC patients. Methods Literature searches on MEDLINE, EMBASE, Cochrane CENTRAL and Lilacs/Bireme were performed for studies published until December 2020. Measured outcomes included clinical efficacy, stricture recurrence, cumulative recurrencefree rate, transplant rate, 5-year survival rate, and adverse events (i.e., pancreatitis, cholangitis, bleeding, perforation and death). Results A total of 5 studies (n=467) were included. Based on pooled analyses, there were no differences in clinical efficacy (risk difference [RD], -0.13; 95% confidence interval [CI], -0.58 to 0.33; I2=93%) or transplant rates (RD, -0.09; 95% CI, -0.19 to 0.01; I2=0%); however, the risk of occurrence of adverse events was lower with balloon dilatation than with stent placement (RD,-0.34; 95% CI, -0.45 to -0.23; I2=61%). Among the types of adverse events reported, only the rates of cholangitis/bacteremia were significantly lower in balloon dilation patients (RD, -0.19; 95% CI, -0.25 to -0.13; I2=51%). Conclusions Compared to balloon dilation, stent placement for dominant strictures in PSC appeared to have higher complication rates without significant differences in efficacy.
Item Description:2234-2400
2234-2443
10.5946/ce.2021.052

Similar Items