Umair Iqbal, MD1, Michael Yodice, MD1, Zohaib Ahmed, MD2, Wade M.. Lee-Smith, MLS3, Douglas G. Adler, MD4, Bradley D. Confer, DO1 1Geisinger Medical Center, Danville, PA; 2University of Toledo Health Sciences Center, Toledo, OH; 3University of Toledo, Toledo, OH; 4Center for Advanced Therapeutic (CATE), Centura Health, Porter Adventist Hospital, Peak Gastroenterology, Denver, CO
Introduction: The current standard of practice is to use a duodenoscope for the evaluation of major duodenal papilla (MDP). Recently, cap-assisted endoscopy (CAE) which uses a transparent cap at the tip of a standard front-viewing endoscope emerged as an alternative. However, data is limited and results are conflicting, some studies showed it is equivalent to a duodenoscope while some showed it inferior to a duodenoscope for the evaluation of MDP. We performed a systematic review and meta-analysis to evaluate the efficacy of CAE for the evaluation of MDP.
Methods: A systematic literature search was performed at Embase, MEDLINE, Cochrane Central Register of Controlled, the Web of Science Core Collection, KCI-Korean Journal Index, SciELO, and the Global Index Medicus suite of global regional databases from inception to January 2023 to identify studies evaluating the efficacy of CAE for the evaluation of MDP. Our primary outcome was the technical success of CAE which is defined as the complete evaluation of MDP.
Results: A total of nine studies including 806 met our inclusion criteria. There were three randomized controlled trials and six observational studies. The pooled rate of technical success for CAE was 93.2% [85.6%-96.9%, I2=84.6]. A subgroup analysis comparing CAE with standard endoscope showed higher odds for the evaluation of MDP with CAE with OR=57.294 [17.767-184.755], I2=45.303. Another subgroup analysis comparing CAE with duodenoscopy showed lower odds with CAE for the evaluation of MDP with OR=0.354 [0.169-0.742], I2=0.
Discussion: CAE is a reasonable alternative to a duodenoscope for the evaluation of MDP. However, further comparative studies are needed before it can replace the duodenoscope as a standard of practice.
Disclosures:
Umair Iqbal indicated no relevant financial relationships.
Michael Yodice indicated no relevant financial relationships.
Zohaib Ahmed indicated no relevant financial relationships.
Wade Lee-Smith indicated no relevant financial relationships.
Douglas Adler indicated no relevant financial relationships.
Bradley Confer: Boston Scientific Corporation – Consultant.
Umair Iqbal, MD1, Michael Yodice, MD1, Zohaib Ahmed, MD2, Wade M.. Lee-Smith, MLS3, Douglas G. Adler, MD4, Bradley D. Confer, DO1. P3399 - Efficacy of Cap Assisted Endoscopy for the Visualization of Major Duodenal Papilla: A Systematic Review and Meta-Analysis, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.
