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KMID : 1038120170500040388
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Clinical Endoscopy
2017 Volume.50 No. 4 p.388 ~ p.394
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There Is No Advantage to Transpapillary Pancreatic Duct Stenting for the Transmural Endoscopic Drainage of Pancreatic Fluid Collections: A Meta-Analysis
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Amin Sunil
Yang Dennis J.
Lucas Aimee L.
Gonzalez Susana
DiMaio Christopher J.
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Abstract
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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).
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KEYWORD
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Pancreatic pseudocyst, Drainage, Endoscopy, Pancreatic fluid collection, Endoscopic retrograde pancreatography
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