PMID- 34026217
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220423
IS  - 2052-0034 (Print)
IS  - 2052-0034 (Electronic)
VI  - 9
IP  - 2
DP  - 2021 Apr
TI  - Endoscopic pancreatic duct stenting for pain palliation in selected pancreatic 
      cancer patients: a systematic review and meta-analysis.
PG  - 105-114
LID - 10.1093/gastro/goab001 [doi]
AB  - BACKGROUND: Abdominal pain is a debilitating symptom affecting  approximately 80% of pancreatic 
      cancer (PC) patients. Pancreatic duct (PD) decompression has been reported to 
      alleviate this pain, although this practice has not been widely adopted. We aimed 
      to evaluate the role, efficacy, and safety of endoscopic PD decompression for 
      palliation of PC post-prandial obstructive-type pain. METHODS: A systematic 
      review until 7 October 2020 was performed. Two independent reviewers selected 
      studies, extracted data, and assessed the methodological quality. RESULTS: We 
      identified 12 publications with a total of 192 patients with PC presenting with 
      abdominal pain, in whom PD decompression was attempted, and was successful in 167 
      patients (mean age 62.5 years, 58.7% males). The use of plastic stents was 
      reported in 159 patients (95.2%). All included studies reported partial or 
      complete improvement in pain levels after PD stenting, with an improvement rate 
      of 93% (95% confidence interval, 79%-100%). The mean duration of pain improvement 
      was 94 +/- 16 days. Endoscopic retrograde cholangiopancreatography (ERCP)-related 
      adverse events (AEs) were post-sphincterotomy bleeding (1.8%), post-ERCP 
      pancreatitis (0.6%), and hemosuccus pancreaticus (0.6%). AEs were not reported in 
      two patients who underwent endoscopic ultrasound-guided PD decompression. In the 
      167 patients with technical success, the stent-migration and stent-occlusion 
      rates were 3.6% and 3.0%, respectively. No AE-related mortality was reported. The 
      methodological quality assessment showed the majority of the studies having low 
      or unclear quality. CONCLUSION: In this exploratory analysis, endoscopic PD 
      drainage may be an effective and safe option in selected patients for the 
      management of obstructive-type PC pain. However, a randomized-controlled trial is 
      needed to delineate the role of this invasive practice.
CI  - (c) The Author(s) 2021. Published by Oxford University Press and Sixth Affiliated 
      Hospital of Sun Yat-sen University.
FAU - Siddappa, Pradeep K
AU  - Siddappa PK
AD  - Division of Gastroenterology and Hepatology, Stanford University School of 
      Medicine, Stanford, CA, USA.
FAU - Hawa, Fadi
AU  - Hawa F
AD  - Department of Internal Medicine, St. Joseph Mercy Ann Arbor Hospital, Ypsilanti, 
      MI, USA.
FAU - Prokop, Larry J
AU  - Prokop LJ
AD  - Library Public Services, Mayo Clinic, Rochester, MN, USA.
FAU - Murad, M Hassan
AU  - Murad MH
AD  - Robert D and Patricia E Kern Center for the Science of Health Care Delivery, Mayo 
      Clinic, Rochester, MN, USA.
FAU - Abu Dayyeh, Barham K
AU  - Abu Dayyeh BK
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
FAU - Chandrasekhara, Vinay
AU  - Chandrasekhara V
AUID- ORCID: 0000-0001-6209-9905
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
FAU - Topazian, Mark D
AU  - Topazian MD
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
FAU - Bazerbachi, Fateh
AU  - Bazerbachi F
AUID- ORCID: 0000-0003-4599-2042
AD  - Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical 
      School, Boston, MA, USA.
LA  - eng
PT  - Journal Article
DEP - 20210203
PL  - England
TA  - Gastroenterol Rep (Oxf)
JT  - Gastroenterology report
JID - 101620508
PMC - PMC8128017
OTO - NOTNLM
OT  - Endoscopic retrograde cholangiopancreatography
OT  - cancer-associated pain
OT  - meta-analysis
OT  - palliative therapy
OT  - pancreas cancer
OT  - systematic review
EDAT- 2021/05/25 06:00
MHDA- 2021/05/25 06:01
PMCR- 2021/02/03
CRDT- 2021/05/24 08:09
PHST- 2020/10/11 00:00 [received]
PHST- 2021/01/03 00:00 [revised]
PHST- 2021/01/05 00:00 [accepted]
PHST- 2021/05/24 08:09 [entrez]
PHST- 2021/05/25 06:00 [pubmed]
PHST- 2021/05/25 06:01 [medline]
PHST- 2021/02/03 00:00 [pmc-release]
AID - goab001 [pii]
AID - 10.1093/gastro/goab001 [doi]
PST - epublish
SO  - Gastroenterol Rep (Oxf). 2021 Feb 3;9(2):105-114. doi: 10.1093/gastro/goab001. 
      eCollection 2021 Apr.