Outcomes of balloon vs basket catheter for clearance of choledocholithiasis: a systematic review and meta-analysis.

Background and study aims  Endoscopic retrograde cholangiopancreatography (ERCP) is the mainstay for treatment of choledocholithiasis. It is unclear whether balloon or basket catheters are better for extraction of stones ≤ 10 mm in size. We performed a meta-analysis of studies comparing rates of complete stone extraction and adverse events after ERCP using balloon vs basket catheters for bile duct stones ≤ 10 mm in size. Methods  Cochrane database, PubMed, Web of Science, and Embase were searched from inception to October 2021. Randomized control trials comparing outcomes of balloon vs basket catheter were included. Data extraction of articles was carried out by two authors using predefined inclusion criteria. Metanalysis was carried out using the Revman 5.4.1. software using a random-effects model. Results  Three studies with a total of 508 patients were included in the final analysis. For common bile duct stones ≤ 10 mm, balloon catheters had higher complete stone clearance rates than basket catheters (relative risk 1.1, confidence interval 1.03, 1.18, P  = 0.006). Heterogeneity among studies was low (Tau 2  = 0.0; P  = 0.47, I 2  = 0 %). There was no difference in the rate of complications. Conclusions  Meta-analysis of three studies indicates that balloon catheters have a higher success rate compared to basket catheters for complete stone extraction for choledocholithiasis ≤ 10 mm with no significant difference in the rate of complications.

Endoscopy international open. 2022 Nov 15*** epublish ***

Ruchi Sharma, Vikram Sharma, Umang Singhal, Madhusudhan Sanaka

Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States., Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, United States., Digestive Disease Institute, Department of Gastroenterology & Hepatology, Cleveland Clinic, Cleveland, Ohio, United States.