Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access
Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc
Journal website https://www.gastrores.org

Original Article

Volume 16, Number 2, April 2023, pages 105-117

Incidence and Cross-Continents Differences in Endoscopic Retrograde Cholangiopancreatography Outcomes Among Patients With Cirrhosis: A Systematic Review and Meta-Analysis

Figures

Figure 1.
Figure 1. PRISMA flowchart for selection process. PRISMA: preferred reporting items for systematic reviews and meta-analyses; NIS: Nationwide Inpatient Sample.
Figure 2.
Figure 2. Meta-analysis of included studies reporting overall post-ERCP complications in patients with liver cirrhosis. ERCP: endoscopic retrograde cholangiopancreatography; CI: confidence interval.
Figure 3.
Figure 3. Meta-analysis of included studies reporting bleeding rate in patients with liver cirrhosis undergoing ERCP. ERCP: endoscopic retrograde cholangiopancreatography; CI: confidence interval; ES: effect size.
Figure 4.
Figure 4. Meta-analysis of included studies reporting post-ERCP pancreatitis (PEP) rate in patients with liver cirrhosis. ERCP: endoscopic retrograde cholangiopancreatography; CI: confidence interval; ES: effect size.
Figure 5.
Figure 5. Meta-analysis of included studies reporting cholangitis rate in patient with liver cirrhosis undergoing ERCP. ERCP: endoscopic retrograde cholangiopancreatography; CI: confidence interval.
Figure 6.
Figure 6. Meta-analysis of included studies reporting perforation rate in patient with liver cirrhosis undergoing ERCP. ERCP: endoscopic retrograde cholangiopancreatography; CI: confidence interval.
Figure 7.
Figure 7. Meta-analysis of included studies reporting mortality rate in patient with liver cirrhosis undergoing ERCP. ERCP: endoscopic retrograde cholangiopancreatography; CI: confidence interval.
Figure 8.
Figure 8. Funnel plot and Egger’s regression test.

Tables

Table 1. Characteristics of the Studies Included in the Meta-Analysis
 
Study, year of publicationCountryContinentStudy designSingle-center or multi-centerStudy periodNumber of cirrhotic patients
Yang et al, 2022 [9]ChinaAsiaRetrospectiveSingle-centerUnspecified131
Lu et al, 2022 [16]ChinaAsiaRetrospectiveSingle-center2010 - 201775
Bernshteyn et al, 2021 [10]USANorth AmericaRetrospectiveSingle-center2013 - 2019174
Jagtap et al, 2019 [11]IndiaAsiaRetrospectiveSingle-center2012 - 2016261
Yoo et al, 2019 [12]USANorth AmericaRetrospectiveSingle-center2016 - 201936
Kim et al, 2019 [13]KoreaAsiaRetrospectiveSingle-center2005 - 2015192
Leal et al, 2019 [15]SpainEuropeRetrospectiveMulti-center2002 - 2015158
Peiseler et al, 2018 [14]USANorth AmericaRetrospectiveSingle-center2009 - 201770
Lee et al, 2018 [24]KoreaAsiaRetrospectiveSingle-center2005 - 2016146
Macias-Rodriguez et al, 2017 [21]MexicoSouth AmericaRetrospectiveSingle-center2009 - 201437
Baffy et al, 2016 [25]USANorth AmericaRetrospectiveSingle-center2012 - 201556
Gill et al, 2016 [26]PakistanAsiaRetrospectiveSingle-center2008 - 2014100
Churrango et al, 2016 [27]USANorth AmericaRetrospectiveSingle-center2008 - 2015194
Adler et al, 2016 [22]USANorth AmericaRetrospectiveMulti-center2003 - 2014328
Zhang et al, 2015 [4]ChinaAsiaRetrospectiveSingle-center2000 - 201477
Li et al, 2014 [20]ChinaAsiaRetrospectiveSingle-center2000 - 200846
Ma et al, 2013 [23]ChinaAsiaRetrospectiveSingle-center2002 - 201341
Artifon et al, 2011 [28]BrazilSouth AmericaProspectiveMulti-centerUnspecified105
Schlenker et al, 2006 [29]USANorth AmericaRetrospectiveSingle-center1994 - 200423
Freeman et al, 1996 [19]USA and CanadaNorth AmericaProspectiveMulti-center1992 - 199464
Prat et al, 1996 [30]FranceEuropeRetrospectiveMulti-centerUnspecified52

 

Table 2. Summary of Post-ERCP Complications Rates
 
Post-ERCP complicationComplication rate (CI)P value
ERCP: endoscopic retrograde cholangiopancreatography; CI: confidence interval.
Bleeding5.10% (3.33 - 7.19)< 0.001
Pancreatitis3.21% (2.20 - 4.36)0.03
Perforation3.02% (1.19 - 5.52)< 0.001
Cholangitis0.12% (0.00 - 0.45)0.26
Mortality0.22% (0.00 - 0.85)0.01