Comparative outcomes of endoscopic ultrasound-guided lumen-apposing mental stents drainage for pancreatic pseudocysts and walled-off necrosis: Case series and meta-analysis

Background: Endoscopic ultrasound (EUS)-guided transmural drainage for pancreatic fluid collections (PFCs) has become the first-line treatment with quicker recovery and more minor injury compared with surgery and percutaneous drainage. The efficacy of stents implantation and drainage for different P...

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Autores principales:	Jing Li, Qian Zhang, Anni Zhou, Guiping Zhao, Peng Li
Formato:	article
Lenguaje:	EN
Publicado:	KeAi Communications Co., Ltd. 2021
Materias:	Pancreatic pseudocyst Walled-off necrosis Endoscopic treatment Lumen-apposing metal stents Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/b86fe910f4c448dcb78a5cc066211d47
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spelling	oai:doaj.org-article:b86fe910f4c448dcb78a5cc066211d472021-12-02T15:08:47ZComparative outcomes of endoscopic ultrasound-guided lumen-apposing mental stents drainage for pancreatic pseudocysts and walled-off necrosis: Case series and meta-analysis2095-882X10.1016/j.cdtm.2021.07.001https://doaj.org/article/b86fe910f4c448dcb78a5cc066211d472021-09-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2095882X21000475https://doaj.org/toc/2095-882XBackground: Endoscopic ultrasound (EUS)-guided transmural drainage for pancreatic fluid collections (PFCs) has become the first-line treatment with quicker recovery and more minor injury compared with surgery and percutaneous drainage. The efficacy of stents implantation and drainage for different PFCs remains controversial, especially lumen-apposing metal stents (LAMS). This study aimed to compare the efficacy and safety of LAMS drainage for pancreatic pseudocysts (PPC) and walled-off necrosis (WON). Methods: A meta-analysis was performed for LAMS drainage for WON and PPC by systematically searching PubMed, Cochrane, and Embase databases from January 2010 to January 2020. From 2017 to 2019, 12 patients who were treated with LAMS drainage for PFCs in our medical center were also reviewed and included in this study. Results: Combining 11 copies of documents with the data from our medical center, a total of 585 patients with PFCs were enrolled in this meta-analysis, including 343 patients with WON and 242 with PPC. The technical success rate in WON is not significantly different from that of PPC (P = 0.08 > 0.05). The clinical success of LAMS placement was achieved in 99% vs 89% in PPC and WON, respectively (RR = 0.92, 95% CI: 0.86–0.98, P = 0.01 < 0.05). The further intervention of direct endoscopic necrosectomy was required by 60% of patients in WON group. There was no significant difference in the incidence of adverse events, including infection, bleeding, stent migration and stent occlusion, after LAMS placement between WON and PPC. Conclusions: Endoscopic ultrasound-guided LAMS for PFCs are feasible, effective with preferable technical and clinical success rates. The clinical effect of LAMS on PPC is slightly better than that of WON, but its adverse reactions still need to be verified in a large-sample prospective study.Jing LiQian ZhangAnni ZhouGuiping ZhaoPeng LiKeAi Communications Co., Ltd.articlePancreatic pseudocystWalled-off necrosisEndoscopic treatmentLumen-apposing metal stentsMedicine (General)R5-920ENChronic Diseases and Translational Medicine, Vol 7, Iss 3, Pp 157-168 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Pancreatic pseudocyst Walled-off necrosis Endoscopic treatment Lumen-apposing metal stents Medicine (General) R5-920
spellingShingle	Pancreatic pseudocyst Walled-off necrosis Endoscopic treatment Lumen-apposing metal stents Medicine (General) R5-920 Jing Li Qian Zhang Anni Zhou Guiping Zhao Peng Li Comparative outcomes of endoscopic ultrasound-guided lumen-apposing mental stents drainage for pancreatic pseudocysts and walled-off necrosis: Case series and meta-analysis
description	Background: Endoscopic ultrasound (EUS)-guided transmural drainage for pancreatic fluid collections (PFCs) has become the first-line treatment with quicker recovery and more minor injury compared with surgery and percutaneous drainage. The efficacy of stents implantation and drainage for different PFCs remains controversial, especially lumen-apposing metal stents (LAMS). This study aimed to compare the efficacy and safety of LAMS drainage for pancreatic pseudocysts (PPC) and walled-off necrosis (WON). Methods: A meta-analysis was performed for LAMS drainage for WON and PPC by systematically searching PubMed, Cochrane, and Embase databases from January 2010 to January 2020. From 2017 to 2019, 12 patients who were treated with LAMS drainage for PFCs in our medical center were also reviewed and included in this study. Results: Combining 11 copies of documents with the data from our medical center, a total of 585 patients with PFCs were enrolled in this meta-analysis, including 343 patients with WON and 242 with PPC. The technical success rate in WON is not significantly different from that of PPC (P = 0.08 > 0.05). The clinical success of LAMS placement was achieved in 99% vs 89% in PPC and WON, respectively (RR = 0.92, 95% CI: 0.86–0.98, P = 0.01 < 0.05). The further intervention of direct endoscopic necrosectomy was required by 60% of patients in WON group. There was no significant difference in the incidence of adverse events, including infection, bleeding, stent migration and stent occlusion, after LAMS placement between WON and PPC. Conclusions: Endoscopic ultrasound-guided LAMS for PFCs are feasible, effective with preferable technical and clinical success rates. The clinical effect of LAMS on PPC is slightly better than that of WON, but its adverse reactions still need to be verified in a large-sample prospective study.
format	article
author	Jing Li Qian Zhang Anni Zhou Guiping Zhao Peng Li
author_facet	Jing Li Qian Zhang Anni Zhou Guiping Zhao Peng Li
author_sort	Jing Li
title	Comparative outcomes of endoscopic ultrasound-guided lumen-apposing mental stents drainage for pancreatic pseudocysts and walled-off necrosis: Case series and meta-analysis
title_short	Comparative outcomes of endoscopic ultrasound-guided lumen-apposing mental stents drainage for pancreatic pseudocysts and walled-off necrosis: Case series and meta-analysis
title_full	Comparative outcomes of endoscopic ultrasound-guided lumen-apposing mental stents drainage for pancreatic pseudocysts and walled-off necrosis: Case series and meta-analysis
title_fullStr	Comparative outcomes of endoscopic ultrasound-guided lumen-apposing mental stents drainage for pancreatic pseudocysts and walled-off necrosis: Case series and meta-analysis
title_full_unstemmed	Comparative outcomes of endoscopic ultrasound-guided lumen-apposing mental stents drainage for pancreatic pseudocysts and walled-off necrosis: Case series and meta-analysis
title_sort	comparative outcomes of endoscopic ultrasound-guided lumen-apposing mental stents drainage for pancreatic pseudocysts and walled-off necrosis: case series and meta-analysis
publisher	KeAi Communications Co., Ltd.
publishDate	2021
url	https://doaj.org/article/b86fe910f4c448dcb78a5cc066211d47
work_keys_str_mv	AT jingli comparativeoutcomesofendoscopicultrasoundguidedlumenapposingmentalstentsdrainageforpancreaticpseudocystsandwalledoffnecrosiscaseseriesandmetaanalysis AT qianzhang comparativeoutcomesofendoscopicultrasoundguidedlumenapposingmentalstentsdrainageforpancreaticpseudocystsandwalledoffnecrosiscaseseriesandmetaanalysis AT annizhou comparativeoutcomesofendoscopicultrasoundguidedlumenapposingmentalstentsdrainageforpancreaticpseudocystsandwalledoffnecrosiscaseseriesandmetaanalysis AT guipingzhao comparativeoutcomesofendoscopicultrasoundguidedlumenapposingmentalstentsdrainageforpancreaticpseudocystsandwalledoffnecrosiscaseseriesandmetaanalysis AT pengli comparativeoutcomesofendoscopicultrasoundguidedlumenapposingmentalstentsdrainageforpancreaticpseudocystsandwalledoffnecrosiscaseseriesandmetaanalysis
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Comparative outcomes of endoscopic ultrasound-guided lumen-apposing mental stents drainage for pancreatic pseudocysts and walled-off necrosis: Case series and meta-analysis

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