PDF(Pubmed)
Abstract：
BACKGROUND: There is a discrepancy in the surgical and endoscopic literature for managing duodenal perforations. Although often managed conservatively, surgical repair is the standard treatment for duodenal perforations. This contrasts with the gastroenterology literature, which now recommends endoscopic repair of duodenal perforations, which are more frequently iatrogenic from the growing field of advanced endoscopic procedures. This study aims to provide a scoping review to summarize the current literature content and quality on endoscopic repair of duodenal perforations.
METHODS: The protocol for performing this scoping review was outlined by the Joanna Briggs Institute. All studies that reported primary outcomes of patients who had undergone endoscopic repair of duodenal perforations before February 2022, regardless of perforation etiology or repair type were reviewed, with studies after 1999 meeting inclusion criteria. The study excluded articles that did not report clinical outcomes of endoscopic repair, articles that did not describe where in the gastrointestinal tract the endoscopic repair occurred, pediatric patients, and animal studies.
RESULTS: 7606 abstracts were screened, with 474 full articles reviewed and 152 studies met inclusion criteria. 560 patients had duodenal perforations repaired endoscopically, with a technical success rate of 90.4% and a survival rate of 86.7%. Most of these perforations (74.5%) were iatrogenic from endoscopic procedures or surgery. Only one randomized control trial (RCT) was found, and 53% of studies were case reports.
CONCLUSIONS: These results suggest that endoscopic repair could emerge as a viable first-line treatment for duodenal perforation and highlight the need for more high-quality research in this topic.
METHODS: The protocol for performing this scoping review was outlined by the Joanna Briggs Institute. All studies that reported primary outcomes of patients who had undergone endoscopic repair of duodenal perforations before February 2022, regardless of perforation etiology or repair type were reviewed, with studies after 1999 meeting inclusion criteria. The study excluded articles that did not report clinical outcomes of endoscopic repair, articles that did not describe where in the gastrointestinal tract the endoscopic repair occurred, pediatric patients, and animal studies.
RESULTS: 7606 abstracts were screened, with 474 full articles reviewed and 152 studies met inclusion criteria. 560 patients had duodenal perforations repaired endoscopically, with a technical success rate of 90.4% and a survival rate of 86.7%. Most of these perforations (74.5%) were iatrogenic from endoscopic procedures or surgery. Only one randomized control trial (RCT) was found, and 53% of studies were case reports.
CONCLUSIONS: These results suggest that endoscopic repair could emerge as a viable first-line treatment for duodenal perforation and highlight the need for more high-quality research in this topic.
摘要：
背景：在治疗十二指肠穿孔的外科和内窥镜文献中存在差异。尽管经常保守地管理，手术修复是十二指肠穿孔的标准治疗方法。这与胃肠病学文献相反，现在建议内镜修复十二指肠穿孔，从先进的内窥镜手术的不断发展的领域中更常见的医源性。本研究旨在对十二指肠穿孔内镜修复的文献内容和质量进行综述。
方法：JoannaBriggsInstitute概述了进行该范围审查的方案。所有报告在2022年2月之前接受过十二指肠穿孔内镜修复的患者的主要结局的研究，无论穿孔的病因或修复类型如何，都进行了回顾。1999年后的研究符合纳入标准。该研究排除了未报告内镜修复临床结果的文章，没有描述内镜修复在胃肠道发生的地方的文章，儿科患者,和动物研究。
结果：筛选了7606篇摘要，共审查了474篇完整文章,152项研究符合纳入标准.560例十二指肠穿孔经内镜修复，技术成功率90.4%,成活率86.7%。这些穿孔中的大多数（74.5％）是由内窥镜手术或手术引起的。仅发现一项随机对照试验（RCT），53%的研究是病例报告。
结论：这些结果表明，内镜下修复术可以作为十二指肠穿孔的可行一线治疗方法出现，并强调需要更多高质量的研究。
方法：JoannaBriggsInstitute概述了进行该范围审查的方案。所有报告在2022年2月之前接受过十二指肠穿孔内镜修复的患者的主要结局的研究，无论穿孔的病因或修复类型如何，都进行了回顾。1999年后的研究符合纳入标准。该研究排除了未报告内镜修复临床结果的文章，没有描述内镜修复在胃肠道发生的地方的文章，儿科患者,和动物研究。
结果：筛选了7606篇摘要，共审查了474篇完整文章,152项研究符合纳入标准.560例十二指肠穿孔经内镜修复，技术成功率90.4%,成活率86.7%。这些穿孔中的大多数（74.5％）是由内窥镜手术或手术引起的。仅发现一项随机对照试验（RCT），53%的研究是病例报告。
结论：这些结果表明，内镜下修复术可以作为十二指肠穿孔的可行一线治疗方法出现，并强调需要更多高质量的研究。
