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| 1 | Efficacy of pancreatoscopy for pancreatic duct stones:A systematic review and meta-analysis显示文摘BACKGROUND Pancreatic duct stones can lead to significant abdominal pain for patients.Per oral pancreatoscopy(POP)-guided intracorporal lithotripsy is being increasingly used for the management of main pancreatic duct calculi(PDC)in chronic pancreatitis.POP uses two techniques:Electrohydraulic lithotripsy(EHL)and laser lithotripsy(LL).Data on the safety and efficacy are limited for this procedure.We performed a systematic review and meta-analysis with a primary aim to calculate the pooled technical and clinical success rates of POP.The secondary aim was to assess pooled rates of technical success,clinical success for the two individual techniques,and adverse event rates.AIM To perform a systematic review and meta-analysis of POP,EHL and LL for management of PDC in chronic pancreatitis.METHODS We conducted a comprehensive search of multiple electronic databases and conference proceedings including PubMed,EMBASE,Cochrane,Google Scholar and Web of Science databases(from 1999 to October 2019)to identify studies with patient age greater than 17 and any gender that reported on outcomes of POP,EHL and LL.The primary outcome assessed involved the pooled technical success and clinical success rate of POP.The secondary outcome included the pooled technical success and clinical success rate for EHL and LL.We also assessed the pooled rate of adverse events for POP,EHL and LL including a subgroup analysis for the rate of adverse event subtypes for POP:Hemorrhage,post-endoscopic retrograde cholangiopancreatography pancreatitis(PEP),perforation,abdominal pain,fever and infections.Technical success was defined as the rate of clearing pancreatic duct stones and clinical success as the improvement in pain.Randomeffects model was used for analysis.Heterogeneity between study-specific estimates was calculated using the Cochran Q statistical test and I2 statistics.Publication bias was ascertained,qualitatively by visual inspection of funnel plot and quantitatively by the Egger test.RESULTS A total of 16 studies including 383 patients met the inclusion criteria.The technical success rate of POP was 76.4%(95%CI:65.9-84.5;I2=64%)and clinical success rate was 76.8%(95%CI:65.2-85.4;I2=66%).The technical success rate of EHL was 70.3%(95%CI:57.8-80.3;I2=36%)and clinical success rate of EHL was 66.5%(95%CI:55.2-76.2;I2=19%).The technical success rate of LL was 89.3%(95%CI:70.5-96.7;I2=70%)and clinical success rate of LL was 88.2%(95%CI:66.4-96.6;I2=77%).The incidence of pooled adverse events for POP was 14.9%(95%CI:9.2-23.2;I2=49%),for EHL was 11.2%(95%CI:5.9-20.3;I2=15%)and for LL was 13.1%(95%CI:6.3-25.4;I2=31%).Subgroup analysis of adverse events showed rates of PEP at 7%(95%CI:3.5-13.6;I2=38%),fever at 3.7%(95%CI:2-6.9;I2=0),abdominal pain at 4.7%(95%CI:2.7-7.8;I2=0),perforation at 4.3%(95%CI:2.1-8.4;I2=0),hemorrhage at 3.4%(95%CI:1.7-6.6;I2=0)and no mortality.There was evidence of publication bias based on funnel plot analysis and Egger’s test.CONCLUSION Our study highlights the high technical and clinical success rates for POP,EHL and LL.POP-guided lithotripsy could be a viable option for management of chronic pancreatitis with PDC. | Syed M Saghir Harmeet S Mashiana Babu P Mohan Banreet S Dhindsa Amaninder Dhaliwal Saurabh Chandan Neil Bhogal Ishfaq Bhat Shailender Singh Douglas G Adler | 2020 | World Journal of Gastroenterology2020，26，34： | 5 |
| 2 | Leaf senescence and lipid peroxidation: Effects of some phytohormones,and scavengers of free radicals and singlet oxygen显示文摘 | Dhindsa R S Plumb-Dhindsa P L Reid D M | 1982 | Physiol Plantarum1982，56，： | 1 |
| 3 | Evaluation of variable speed limits for real-time freeway safety improvement显示文摘 | ABDEL-ATY M DILMORE J DHINDSA A | 2006 | Accident Analysis and Prevention2006，38，2： | 1 |
| 4 | Leaf senes-cence and lipid peroxidation:effect of some phytohormones andscavengers of free radicals and singlet oxygen显示文摘 | DHINDSA R S PLUMB-DHINDSA P L RIED D M | 1982 | Physiol Plant1982，56，： | 1 |
| 5 | Effects of swimming training on blood pressure and vascular function in adults >50 years of age显示文摘 | Nualnim N Parkhurst K Dhindsa M | 2012 | Am J Cardiol2012，109，7： | 1 |
| 6 | Leat senescence and lipidper oxidation: Effects of some phytohorm ones,and scavengers of free radicals and singlet oxygen显示文摘 | Dhindsa R S Dhindsa P P Reid D M | 1982 | Physiol Plant1982，56，： | 1 |
| 7 | Drug-eluting stents:new era and new concerns显示文摘 | Bhatia R Dhindsa M | 2004 | Postgrad Med2004，80，： | 1 |
| 8 | Insulin resistance,insulin sensitization and inflammation in polycystic ovarian syndrome显示文摘 | Dhindsa G Bhatia R Dhindsa M | 2004 | J Postgrad Med2004，50，2： | 1 |
| 9 | Evaluation of variable speed limits for real-time freeway safety improvement显示文摘 | ABDEL A M DILMORE J DHINDSA A | 2006 | Accident Analysis & Prevent ion2006，38，2： | 1 |
| 10 | Leaf senescence and lipid peroxidation: Effects of some phytohormones, and scavengers of free radicals and singlet oxygen 显示文摘 | Dhindsa R S Plumb-Dhindsa P L Reid D M | 1982 | Physiologia Plantarum1982，56，4： | 1 |
| 11 | Leat senescence and lipidper oxidation: Effects of some phytohorm ones,and scavengers of free radicals and slnglet oxygen 显示文摘 | DHINDSA R S DHINDSA P P REID D M | 1982 | Physiol Plant1982，56，： | 1 |
| 12 | Drug-eluting stents:new era and new concerns显示文摘 | Bhatia R Dhindsa M | 2004 | Postgrad Med J2004，80，939： | 1 |
| 13 | Drug-eluting stents: new era and new concerns 显示文摘 | Bhatia V Bhatia R Dhindsa M | 2004 | Postgrad Med J2004，80，939： | 1 |
| 14 | Leaf senescence and lipid peroxidation:Effects of some phytohormones and scavengers of free radicals and singlet oxygen显示文摘 | Dhindsa R S Dhindsa P P Reid D M | 1982 | Physiology Plant1982，，56： | 1 |
| 15 | Evaluation of variable speed limits for real-time freeway safety improvement 显示文摘 | ABDEL-ATY M DILMORE J DHINDSA A | 2006 | Accident Analysis and Prevention2006，38，： | 1 |
| 16 | Insulin resistance, insulin sensitization and inflammation in polycystic ovari- an syndrome显示文摘 | Dhindsa G Bhatia R Dhindsa M | 2004 | J Postgrad Med2004，50，： | 1 |
| 17 | A molecular marker to select for freezing tolerance in Gramineae显示文摘 | Houde M Dhindsa R S Sarhan F | 1992 | Mol Gen Genet1992，243，： | 1 |
| 18 | Leaf senescence and lipid peroxidation:Effect of some phytohormones,and scavengers office radicals and singlet oxygen显示文摘 | Dhindsa R S Plumb-Dhindsa P L Reid D M | 1982 | Physiol Plant1982，56，： | 1 |
| 19 | 显示文摘 | BRYCE M R COOKE G DHINDSA A S | 1992 | Tetrahedron Letter1992，333，： | 1 |
| 20 | Leaf senescence and lipid peroxidation:Effect of some phytohormones, and scavengers of free radicals and singlet oxygen 显示文摘 | Dhindsa R S Idhindsa P L Reid D M | 1982 | Physiol Plant1982，56，： | 1 |
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