Evidence map›Paper›PMID 40229855›Full record

SynthesisEuropean journal of medical research2025

Comparison of intratracheal intubation or not during endoscopic retrograde cholangiopancreatography: a meta-analysis and systematic review.

Binfeng Zhang, Zekun Lang, Lei Zhang, Boxiong Gao, Yutong Wang, Yatao Liu

Abstract readSystematic ReviewMeta-AnalysisComparative Study
In one paragraph

Synthesis in European journal of medical research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Binfeng Zhang *Department of Anesthesia and Surgery, First Hospital of Lanzhou University, No. 1 Donggang West Road, Chengguan District, Lanzhou, Gansu, 730000, People's Republic of China.
Zekun Lang *The First Clinical Medical College, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China.
Lei ZhangThe First Clinical Medical College, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China.
Boxiong GaoThe First Clinical Medical College, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China.
Yutong WangThe First Clinical Medical College, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China.
Yatao LiuDepartment of Anesthesia and Surgery, First Hospital of Lanzhou University, No. 1 Donggang West Road, Chengguan District, Lanzhou, Gansu, 730000, People's Republic of China. liuyt@lzu.edu.cn.

Funding

Gansu Provincial Joint Scientific Research Fund Project in 2023 23JRRA1496Gansu Provincial Key Talent Project of the Organization Department of the CPC Gansu Provincial Committee in 2022 23JRRA1496High-end Foreign Project Program of the Ministry of Science and Technology in 2023-2024 G2023175006L
6 · The paper itself

Abstract

objectivesIn endoscopic retrograde cholangiopancreatography anesthesia, both intubation and non-intubation techniques have their own advantages and disadvantages. However, whether either approach is associated with postoperative and anesthesia-related adverse events remains controversial.

methodsWe searched the literature in PubMed, Web of Science, Cochrane Library, Scopus, Ovid and Embase databases up to October 2024. All studies comparing intubated vs. non-intubation anesthesia for endoscopic retrograde cholangiopancreatography were included. The main outcome measures were sedation-related adverse events and death. Data were combined using risk ratio with 95% confidence intervals. The study protocol was prospectively registered with PROSPERO (CRD42024608807).

resultsWe finally included 8 studies with a total of 21,433 patients. Endotracheal intubation was associated with a lower risk of sedation-related adverse events (RR: 2.85, 95% CI 1.33-6.09, p = 0.007). However, the risks of death (RR: 0.59, 95% CI 0.36-0.96, p = 0.03) and intraoperative hypotension (RR: 0.43, 95% CI 0.26-0.69, p = 0.0006) were lower without intubation. In the trial-sequence analysis, the trial-sequence monitoring boundary is crossed, indicating conclusive evidence of a statistically significant effect.

conclusionsOur findings suggest that endotracheal intubation during endoscopic retrograde cholangiopancreatography is associated with a lower risk of sedation-related adverse events but a higher risk of mortality and intraoperative hypotension compared to non-intubation. However, these associations do not establish direct causality and should be interpreted with caution. Further high-quality randomized controlled trials are needed to validate these findings. Clinicians should adopt a patient-centered approach, carefully balancing the potential benefits and risks of intubation to optimize airway management strategies in endoscopic retrograde cholangiopancreatography.

Indexed as

Cholangiopancreatography, Endoscopic RetrogradeIntubation, IntratrachealHumansEndoscopic retrograde cholangiopancreatographyGeneral anesthesiaIntratracheal intubation

Identifiers

PMID40229855
PMCPMC11998158

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.