PMID- 35368320
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220405
IS  - 2515-2092 (Electronic)
IS  - 2515-2084 (Print)
IS  - 2515-2084 (Linking)
VI  - 5
IP  - 2
DP  - 2022 Apr
TI  - Comparative Effectiveness of Lumen-Apposing Metal Stents and Plastic Stents for 
      the Treatment of Pancreatic Walled-Off Necrosis: A Meta-analysis.
PG  - 68-78
LID - 10.1093/jcag/gwab024 [doi]
AB  - BACKGROUND: Plastic stents (PS), lumen-apposing metal stents (LAMS) and biflanged 
      metal stents (BFMS) are used for initial drainage of pancreatic walled-off 
      necrosis (WON). There are no strong evidence to support the use of LAMS/BFMS over 
      PS, and prior systematic reviews lack comparative analyses and also lack both 
      trial data and observational studies for WON efficacy outcomes. The aim of this 
      study is to compare the efficacy and adverse events (AEs) in LAMS/BFMS versus PS 
      in patients with pancreatic WON. METHODS: A comprehensive search up to December 
      1, 2020, was performed. The primary outcome was clinical improvement after 
      drainage. Secondary outcomes included AEs and technical failure. Pooled odds 
      ratios (OR) with 95% confidence intervals (CI) were reported using random effects 
      models. Heterogeneity was evaluated with the Cochrane I (2) statistic. Subgroup 
      and sensitivity analyses were performed. The quality of the evidence was assessed 
      using Grading of Recommendations, Assessment, Development and Evaluations 
      (GRADE). RESULTS: Nine studies (one randomized controlled trial and eight 
      observational) were included for the primary outcome including 493 patients 
      treated with LAMS/BFMS and 514 with PS. LAMS/BFMS were associated with higher 
      odds of clinical improvement compared with PS (OR 2.58; 95% CI 1.81, 3.68; I (2) 
      = 1%). This association remained robust in sensitivity analyses. The use of 
      LAMS/BFMS was not associated with higher AEs (OR 1.22; 0.61, 2.46; I (2) = 71%). 
      There was no difference in technical failure (OR 1.06; 0.19, 6.00; I (2) = 12%). 
      CONCLUSIONS: LAMS/BFMS seem to result in better clinical outcomes compared with 
      PS in patients with pancreatic WON, with comparable AEs and technical failure. 
      Larger randomized controlled trials for this comparison are warranted.
CI  - (c) The Author(s) 2021. Published by Oxford University Press on behalf of the 
      Canadian Association of Gastroenterology.
FAU - Calo, Natalia Causada
AU  - Calo NC
AD  - Division of Gastroenterology, The Ottawa Hospital, University of Ottawa, Ottawa, 
      Ontario, Canada.
FAU - Bishay, Kirles
AU  - Bishay K
AUID- ORCID: 0000-0003-4478-089X
AD  - Division of Gastroenterology, St. Michael's Hospital, University of Toronto, 
      Toronto, Ontario, Canada.
FAU - Yaghoobi, Mohammad
AU  - Yaghoobi M
AD  - Division of Gastroenterology, McMaster University, Hamilton, Ontario, Canada.
FAU - Yuan, Yuhong
AU  - Yuan Y
AD  - Division of Gastroenterology, McMaster University, Hamilton, Ontario, Canada.
FAU - Mosko, Jeffrey
AU  - Mosko J
AD  - Division of Gastroenterology, St. Michael's Hospital, University of Toronto, 
      Toronto, Ontario, Canada.
FAU - May, Gary
AU  - May G
AD  - Division of Gastroenterology, St. Michael's Hospital, University of Toronto, 
      Toronto, Ontario, Canada.
FAU - Chen, Yen-I
AU  - Chen YI
AD  - Division of Gastroenterology, McGill University, Montreal, Quebec, Canada.
FAU - Teshima, Christopher
AU  - Teshima C
AD  - Division of Gastroenterology, St. Michael's Hospital, University of Toronto, 
      Toronto, Ontario, Canada.
LA  - eng
PT  - Journal Article
DEP - 20210807
PL  - England
TA  - J Can Assoc Gastroenterol
JT  - Journal of the Canadian Association of Gastroenterology
JID - 101738684
PMC - PMC8972216
OTO - NOTNLM
OT  - Endoscopic ultrasound
OT  - Lumen-apposing metal stent
OT  - Metal stent
OT  - Pancreatic walled off necrosis
OT  - Pancreatitis
OT  - Peripancreatic fluid collection
OT  - Plastic stent
EDAT- 2022/04/05 06:00
MHDA- 2022/04/05 06:01
PMCR- 2021/08/07
CRDT- 2022/04/04 05:06
PHST- 2021/03/19 00:00 [received]
PHST- 2021/07/15 00:00 [accepted]
PHST- 2022/04/04 05:06 [entrez]
PHST- 2022/04/05 06:00 [pubmed]
PHST- 2022/04/05 06:01 [medline]
PHST- 2021/08/07 00:00 [pmc-release]
AID - gwab024 [pii]
AID - 10.1093/jcag/gwab024 [doi]
PST - epublish
SO  - J Can Assoc Gastroenterol. 2021 Aug 7;5(2):68-78. doi: 10.1093/jcag/gwab024. 
      eCollection 2022 Apr.