Antibiotic Prophylaxis for Peroral Cholangioscopy: A Systematic Review and Meta-analysis.

IF 8 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Gastrointestinal endoscopy Pub Date : 2026-08-20 DOI:10.1016/j.gie.2026.08.018

Tareq Alsaleh, Baha Fawwaz, Mohamad Khaled Almujarkesh, Hamza Akram, Calvin Jose, Nouman Shafique, Amna S Malik, Mustafa Arain, John George

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Abstract

Background and aims: Antibiotic prophylaxis is commonly used before ERCP with peroral cholangioscopy, but supporting evidence is limited. We evaluated whether prophylaxis reduces post-procedural cholangitis after cholangioscopy.

Methods: We searched Embase, PubMed, Web of Science, and Scopus through February 2026 for studies reporting cholangitis stratified by prophylaxis exposure. Random-effects meta-analysis was used to pool risk ratios.

Results: Six studies including 2,531 patients and 2,575 procedures were included. The pooled cholangitis rate was 3.0% with prophylaxis and 7.8% without prophylaxis. Antibiotic prophylaxis was associated with lower cholangitis risk (risk ratio, 0.46; 95% confidence interval, 0.22-0.95; I² = 40.4%), although the estimate was of borderline significance and not robust to individual study removal. Certainty of evidence was very low.

Conclusions: Antibiotic prophylaxis was associated with a reduction in post-cholangioscopy cholangitis that was of borderline significance and sensitive to individual studies. Prospective studies are needed to define optimal patient selection and regimens.

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经口胆道镜的抗生素预防：一项系统回顾和荟萃分析。

背景和目的：ERCP术前经口胆道镜检查通常使用抗生素预防，但支持证据有限。我们评估预防是否能减少胆管镜术后胆管炎。方法：我们检索Embase、PubMed、Web of Science和Scopus，检索截至2026年2月的报告按预防暴露分层的胆管炎的研究。随机效应荟萃分析用于汇总风险比。结果：纳入6项研究，包括2531例患者和2575例手术。合并胆管炎发生率预防为3.0%，未预防为7.8%。抗生素预防与较低的胆管炎风险相关（风险比为0.46；95%可信区间为0.22-0.95;I2 = 40.4%），尽管该估计具有临界意义，对于个别研究的移除并不稳健。证据的确定性非常低。结论：抗生素预防与胆管镜检查后胆管炎的减少相关，这对个体研究具有临界意义和敏感性。需要前瞻性研究来确定最佳的患者选择和治疗方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gastrointestinal endoscopy 医学-胃肠肝病学

CiteScore

10.30

自引率

7.80%

发文量

1441

审稿时长

38 days

期刊介绍： Gastrointestinal Endoscopy is a journal publishing original, peer-reviewed articles on endoscopic procedures for studying, diagnosing, and treating digestive diseases. It covers outcomes research, prospective studies, and controlled trials of new endoscopic instruments and treatment methods. The online features include full-text articles, video and audio clips, and MEDLINE links. The journal serves as an international forum for the latest developments in the specialty, offering challenging reports from authorities worldwide. It also publishes abstracts of significant articles from other clinical publications, accompanied by expert commentaries.