There Is No Advantage to Transpapillary Pancreatic Duct Stenting for the Transmural Endoscopic Drainage of Pancreatic Fluid Collections: A Meta-Analysis.
- Author:
Sunil AMIN
1
;
Dennis J YANG
;
Aimee L LUCAS
;
Susana GONZALEZ
;
Christopher J DIMAIO
Author Information
- Publication Type:Meta-Analysis ; Original Article
- Keywords: Pancreatic pseudocyst; Drainage; Endoscopy; Pancreatic fluid collection; Endoscopic retrograde pancreatography
- MeSH: Drainage*; Endoscopy; Humans; Methods; Odds Ratio; Pancreatic Ducts*; Pancreatic Pseudocyst; Recurrence; Stents*
- From:Clinical Endoscopy 2017;50(4):388-394
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: Options for the endoscopic management of symptomatic pancreatic fluid collections (PFCs) include transmural drainage (TM) alone, transpapillary drainage (TP) alone, or a combination of both drainage method (CD). There have been conflicting reports about the best method. This study performed a meta-analysis to determine whether CD presents an added clinical benefit over TM. METHODS: The included studies compared TM with CD and reported clinical success for both methods. A random-effects model was used to determine the pooled odds ratios (ORs) and the 95% confidence intervals (CIs) for the following outcomes: technical success, clinical success, complications, and recurrence. RESULTS: Nine studies involving a combined total of 604 drainage procedures—373 TMs (62%) and 231 CDs (38%)—were included. CD showed no additional benefit over TM in terms of technical success (OR, 1.12; 95% CI, 0.37–3.37; p=0.85), clinical success (OR, 1.11; 95% CI, 0.65–1.89; p=0.70), recurrence (OR, 1.49; 95% CI, 0.53–4.21; p=0.45), or complications (OR, 1.15; 95% CI, 0.61–2.18; p=0.67). CONCLUSIONS: Pancreatic duct (PD) stenting provides no additional clinical benefit for the TM of PFCs (particularly pseudocysts). Patients undergoing the TM of symptomatic pseudocysts may not require endoscopic retrograde pancreatography (ERP).
