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Meta-Analysis
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Nov 16, 2025; 17(11): 112348
Published online Nov 16, 2025. doi: 10.4253/wjge.v17.i11.112348
Efficacy and safety of double-balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography in surgically altered anatomy: A systematic review and meta-analysis
Guo-Yao Sun, Zhi-Xin Liu, Yong Sun, Zhuo Yang
Guo-Yao Sun, Zhi-Xin Liu, Yong Sun, Zhuo Yang, Department of Endoscopy, General Hospital of Northern Theater Command, Shenyang 110000, Liaoning Province, China
Co-first authors: Guo-Yao Sun and Zhi-Xin Liu.
Co-corresponding authors: Yong Sun and Zhuo Yang.
Author contributions: Sun GY contributed to data curation and visualization; Liu ZX performed formal analysis and software development; and Sun Y and Yang Z was responsible for conceptualization and supervision. Sun GY and Liu ZX have contributed equally to this work. Sun Y and Yang Z served as the principal investigators of this study, providing overall conceptual guidance, supervision of experimental design, and oversight of data interpretation. They were responsible for critical decisions regarding methodology, study direction, and manuscript preparation. Their leadership ensured the scientific rigor and integrity of the research, and both authors contributed equally to the supervision and finalization of the manuscript. Therefore, designating them as co-corresponding authors appropriately reflects their shared responsibility in guiding the study and correspondence with the journal.
Supported by Department of Science and Technology of Liaoning Province, No. 2024JH2/102600288 and No. 2022JH2/101500013.
Conflict-of-interest statement: The authors deny any conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhuo Yang, Chief Physician, Professor, Department of Endoscopy, General Hospital of Northern Theater Command, No. 83 Wenhua Road, Shenhe District, Shenyang 110000, Liaoning Province, China. yangzhuocy@163.com
Received: July 24, 2025
Revised: September 8, 2025
Accepted: October 21, 2025
Published online: November 16, 2025
Processing time: 113 Days and 12.8 Hours
Core Tip

Core Tip: Double-balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography (DBE-ERCP) is a safe and effective approach for the management of pancreatobiliary diseases in patients with surgically altered anatomy. This updated systematic review and meta-analysis of 40 studies including 2689 patients demonstrates high enteroscopic (89%), diagnostic (90%), and procedural (92%) success rates, with a low overall adverse event rate (5.7%). Subgroup analysis indicates that short-type double-balloon enteroscopy (DBE) outperforms long-type DBE in procedural success and papilla access. These findings highlight the clinical utility of DBE-ERCP and suggest that short-type DBE may offer greater advantages, though further randomized controlled trials are warranted.