We aimed to compare enteroscopy-assisted ERCP (EA-ERCP), laparoscopy-assisted ERCP
(LA-ERCP), and endoscopic ultrasound-directed ERCP (EDGE) in terms of safety and efficacy
in post-Roux-en-Y gastric bypass patients. We conducted a rigorous analysis based
on a predefined protocol (PROSPERO, CRD42022368788). Sixty-seven studies were included.
The technical success rates were 77% (CI 69-83%) for EA-ERCP, 93% (CI 91-96%) for
LA-ERCP, and 96% (CI 92-98%) for EDGE. Subgroup differences were significant between
the EA-ERCP and other groups (p < 0.05). The overall adverse event rates were 13%
(CI 8-22%), 19% (CI 14-24%), and 20% (CI 12-31%), respectively (p = 0.49). Our findings
suggest that EDGE and LA-ERCP may be more effective and as safe as EA-ERCP.
