A meta-analysis on endoscopic ultrasound-guided lumen-apposing metal stents placement combined with double-pigtail plastic stents in treatment of pancreatic fluid collection
10.3760/cma.j.cn115667-202401267-00026
- VernacularTitle:超声内镜引导下置入双蘑菇头金属支架联合双猪尾塑料支架治疗胰腺液体积聚的荟萃分析
- Author:
Mengyi LI
1
;
Yiping ZHANG
;
Wei XU
Author Information
1. 中山大学附属第一医院消化内科，广州 510080
- Publication Type:Journal Article
- Keywords:
Ultrasonic endoscope;
Lumen-apposing metal stent;
Double-pigtail plastic stent;
Pancreatic fluid collection;
Meta-analysis
- From:
Chinese Journal of Pancreatology
2024;24(6):439-446
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the efficacy of endoscopic ultrasound-guided (EUS) placement of lumen-apposing metal stent (LAMS) with a coaxial double pigtail plastic stent (DPPS) versus LAMS drainage in the treatment of pancreatic fluid collection (PFC).Methods:"Pancreatic fluid collection, walled-off pancreatic necrosis, pancreatic pseudocyst, lumen-apposing metal stents, double pigtail plastic stent" were used as keywords for research search, and the network database such as PubMed, Embase, Web of Science, Cochrane Library and SinoMed were searched from database establishment to October 2023. Papers on prospective and retrospective cohort studies of EUS-guided LAMS alone and LAMS combined with DPPS (LAMS+DPPS) for the treatment of PFC were searched. All the papers searched were screened and the quality was evaluated according to preset inclusion and exclusion criteria; and the important data were extracted. Metaanalysis was performed using RevMan5.4 and STATA/MP 18.0 software.Results:A total of 7 papers with 533 patients were included. Among them, 260 patients received LAMS, and 273 patients received LAMS+DPPS. The results of metaanalysis showed that the overall risk of adverse events and the risk of stent occlusion were significantly lower in the LAMS+DPPS group than in the LAMS group ( RR=0.66, 95% CI 0.48-0.91; RR=0.55, 95% CI 0.31-0.99, both P values ≤0.05); however, in terms of technical success, clinical success, stent migration, bleeding, infection, and perforation, the difference on the risk of adverse events in the LAMS group and the LAMS+DPPS group were not statistically significant ( RR=1.01, 95% CI 0.98-1.04; RR=1.01, 95% CI 0.91-1.13; RR=0.87, 95% CI 0.41-1.84; RR=0.96, 95% CI 0.50~1.85; RR=0.47, 95% CI 0.20-1.06; RR=0.42, 95% CI 0.06-2.76; all P values >0.05); Conclusions:Compared with LAMS alone, LAMS+DPPS can significantly reduce stent occlusion risk as well as overall risk of adverse events, and it has more advantages than LAMS for the treatment of PFC.
