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CC BY 4.0 · Endosc Int Open
DOI: 10.1055/a-2586-6007
Review

Biliary stent insertion after stone clearance in patients awaiting cholecystectomy: systematic review and meta-analysis

Marco Valvano 
1   Department of Health Sciences, University of L'Aquila Department of Health Sciences, L'Aquila, Italy (Ringgold ID: RIN367958)
2   S.C. Gastroenterologia, Ente Ospedaliero Ospedali Galliera, Genova, Italy (Ringgold ID: RIN9336)
,
Daniele Balducci
3   Università Politecnica delle Marche, Ancona, Italy (Ringgold ID: RIN9294)
,
Antonio Vinci
4   University of Rome Tor Vergata, Roma, Italy (Ringgold ID: RIN9318)
,
Andrea Ghezzi
5   Ente Ospedaliero Ospedali Galliera, Genova, Italy (Ringgold ID: RIN9336)
,
Shirin Djahandideh
5   Ente Ospedaliero Ospedali Galliera, Genova, Italy (Ringgold ID: RIN9336)
,
Stefano Fabiani
6   Pescara Hospital, Pescara, Italy (Ringgold ID: RIN18637)
,
Gianpiero Stefanelli
5   Ente Ospedaliero Ospedali Galliera, Genova, Italy (Ringgold ID: RIN9336)
,
Silvia Buccilli
5   Ente Ospedaliero Ospedali Galliera, Genova, Italy (Ringgold ID: RIN9336)
,
Amedeo Montale
5   Ente Ospedaliero Ospedali Galliera, Genova, Italy (Ringgold ID: RIN9336)
,
Filippo Antonini 
7   Gastroenterology and Digestive Endoscopy, Augusto Murri Hospital, Fermo, Italy
,
Luca Maroni
3   Università Politecnica delle Marche, Ancona, Italy (Ringgold ID: RIN9294)
,
Chiara Campanale
5   Ente Ospedaliero Ospedali Galliera, Genova, Italy (Ringgold ID: RIN9336)
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Background: Laparoscopic cholecystectomy is the standard treatment for patients with cholecystitis or gallbladder stones after common bile duct (CBD) clearance. According to the sequential strategy, the cholecystectomy should be performed within two weeks from CDB clearance with ERCP. However, in real life experience, the average waiting time is 60 – 180 days. We aimed to evaluate the clinical rationale of prophylactic stent placement in CBD to prevent recurrent biliary events. Methods: This systematic review and meta-analysis were performed following a protocol designed a priori (PROSPERO: CRD42024564804; 13July2024). All published studies involving patients who had undergone ERCP for CBDs and awaiting cholecystectomy were included. Results: At the end of the revision process, 4 full texts including 755 patients were included in the meta-analysis. The Odds-Ratio (OR) for a recurrence of symptoms in patients waiting for cholecystectomy was 0.74 (95%CI 0.30-1.79; I2 67%). The pooled OR of adverse events occurrence was 0.74 (95%CI 0.45-1.24) in the stent group. The post-ERCP pancreatitis and cholangitis risk were 0.76 (95%CI 0.25-2.34) and 0.92 (95%CI 0.31-2.67), respectively. Conclusions This meta-analysis showed no benefits of stenting insertion after bile duct clearance in patients scheduled for delayed cholecystectomy. Further randomized controlled trials with bigger cohorts are needed to assess any benefit of this procedure, which, in the meantime, cannot be recommended.



Publication History

Received: 27 October 2024

Accepted after revision: 25 January 2025

Accepted Manuscript online:
14 April 2025

© . The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

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Bibliographical Record
Marco Valvano, Daniele Balducci, Antonio Vinci, Andrea Ghezzi, Shirin Djahandideh, Stefano Fabiani, Gianpiero Stefanelli, Silvia Buccilli, Amedeo Montale, Filippo Antonini, Luca Maroni, Chiara Campanale. Biliary stent insertion after stone clearance in patients awaiting cholecystectomy: systematic review and meta-analysis. Endosc Int Open ; 0: a25866007.
DOI: 10.1055/a-2586-6007