Adverse Events Associated With Endoscopic Retrograde Cholangiopancreatography: Systematic Review and Meta-Analysis.

We aimed to assess incidences and comparisons of ERCP AEs.

我们的目标是评估ERCP不良事件的发生率及其比较。

Methods

We included studies performed after 2000 reporting on ERCP AEs from database inception through March 12, 2024.

我们纳入了2000年以后进行的研究，这些研究报告了从数据库开始到2024年3月12日的内镜逆行胰胆管造影（ERCP）相关不良事件。

Outcomes included pancreatitis, bleeding, cholangitis, cholecystitis, perforation, and death.

结果包括胰腺炎、出血、胆管炎、胆囊炎、穿孔和死亡。

DerSimonian and Laird random effects meta-analyses were performed to calculate incidences of AEs.

使用DerSimonian和Laird随机效应元分析计算不良事件（AEs）的发生率。

Subgroup and pairwise meta-analyses were performed.

执行了亚组和成对元分析。

Meta-regression was performed on median recruitment year to assess temporal trends in pancreatitis incidence.

对中位招募年份进行了元回归分析，以评估胰腺炎发病率的时间趋势。

Results

A total of 380 studies were included.

共纳入了380项研究。

The incidenceof death attributable to ERCP was 0.2% (95% confidence interval[CI], 0.1%-0.3%; I2, 44%; n = 47,258) in all-comers.

在所有接受ERCP的患者中，死亡归因于ERCP的发生率为0.2%（95%置信区间[CI]，0.1%-0.3%；I2, 44%；n = 47,258）。

The overall incidenceof pancreatitis was 4.6% (95% CI, 4.0%-5.1%; I2, 96%; n = 293,378) among all-comers and 6.5% (95% CI, 5.9%-7.1%, I2, 89%; n = 88,809) among first-time patients.

在所有接受ERCP的患者中，胰腺炎的总体发生率为4.6%（95%置信区间[CI]，4.0%-5.1%；I2, 96%；n = 293,378），而在首次接受ERCP的患者中，发生率为6.5%（95%置信区间[CI]，5.9%-7.1%，I2, 89%；n = 88,809）。

Pancreatitis incidenceremained stable between 2000 and 2023 (average annual percent change 0.06, 95% CI, -0.27 to 0.39).

胰腺炎的发病率在2000年至2023年期间保持稳定（平均年变化百分比为0.06，95%置信区间为-0.27至0.39）。

The overall incidences of the following AEs for all-comers were: bleeding (1.5%; 95% CI, 1.2%-1.7%; I2, 93%; n = 229,655), cholangitis (2.5%; 95% CI, 1.9%-3.3%; I2, 96%; n = 121,619), cholecystitis (0.8%; 95% CI, 0.5%-1.2%; I2, 39%; n = 7799), and perforation (0.5%; 95% CI, 0.4%-0.6%; I2, 90%; n = 306,378).

所有患者中以下不良事件的总发生率为：出血（1.5%；95%置信区间为1.2%-1.7%；I2, 93%；n = 229,655），胆管炎（2.5%；95%置信区间为1.9%-3.3%；I2, 96%；n = 121,619），胆囊炎（0.8%；95%置信区间为0.5%-1.2%；I2, 39%；n = 7799），以及穿孔（0.5%；95%置信区间为0.4%-0.6%；I2, 90%；n = 306,378）。

Conclusions

ERCP-associated AEs remain common.

ERCP相关的不良事件仍然很常见。

Incidenceof post-ERCP pancreatitis remained static despite improvements in techniques, prevention, and recognition.

尽管在技术、预防和识别方面有所改进，但ERCP后胰腺炎的发生率仍然保持不变。

These results are important to patients, endoscopists, and policy makers to inform consent and to encourage implementation of available risk mitigation strategies.

这些结果对于患者、内镜医生和政策制定者来说非常重要，它们有助于告知知情同意，并鼓励实施现有的风险缓解策略。