PMID- 37671081
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230907
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 11
IP  - 9
DP  - 2023 Sep
TI  - Early versus late endoscopic treatment of pancreatic necrotic collections: A 
      systematic review and meta-analysis.
PG  - E794-E799
LID - 10.1055/a-2100-9076 [doi]
AB  - Background and study aims Recently studies have compared early (<4 weeks) vs. 
      late or standard (>4 weeks) endoscopic treatment of pancreatic necrotic 
      collections (PNC) and have reported favorable results for early treatment. In 
      this meta-analysis, we compared the efficacy and safety of early vs. late 
      endoscopic treatment of PNC. Patients and methods We reviewed several databases 
      from inception to September 30, 2021 to identify studies that compared early with 
      late endoscopic treatment of PNC. Our outcomes of interest were adverse events 
      (AEs), resolution of PNC, performance of direct endoscopic necrosectomy, need for 
      further interventions, and mean number of endoscopic necrosectomy sessions. We 
      calculated pooled risk ratios (RRs) with 95% confidence intervals (CIs) for 
      categorical variables and mean differences (MDs) with 95% CIs for continuous 
      variables. Data were analyzed by random effect model. Heterogeneity was assessed 
      by I (2) statistic. Results We included four studies with 427 patients. We found 
      no significant difference in rates of AEs, RR (95% CI) 1.70 (range, 0.56-5.20), 
      resolution of necrotic or fluid collections, RR (95% CI) 0.89 (range, 0.71-1.11), 
      need for further interventions, RR (95% CI) 1.47 (range, 0.70-3.08), direct 
      necrosectomy, RR (95% CI) 1.39 (range, 0.22-8.80), mortality, RR (95% CI) 2.37 
      (range, 0.26-21.72) and mean number of endoscopic necrosectomy sessions, MD (95% 
      CI) 1.58 (range,-0.20-3.36) between groups. Conclusions Early endoscopic 
      treatment of PNC can be considered for indications such as infected necrosis or 
      sterile necrosis with symptoms or complications; however, future large 
      multicenter studies are required to further evaluate its safety.
CI  - The Author(s). This is an open access article published by Thieme under the terms 
      of the Creative Commons Attribution-NonDerivative-NonCommercial-License, 
      permitting copying and reproduction so long as the original work is given 
      appropriate credit. Contents may not be used for commercial purposes, or adapted, 
      remixed, transformed or built upon. 
      (https://creativecommons.org/licenses/by-nc-nd/4.0/).
FAU - Kamal, Faisal
AU  - Kamal F
AUID- ORCID: 0000-0002-6842-506X
AD  - Gastroenterology, Thomas Jefferson University Sidney Kimmel Medical College, 
      Philadelphia, United States. RINGGOLD: 12313
FAU - Khan, Muhammad Ali
AU  - Khan MA
AD  - Gastroenterology, The University of Texas MD Anderson Cancer Center, Houston, 
      United States. RINGGOLD: 4002
FAU - Lee-Smith, Wade M
AU  - Lee-Smith WM
AD  - University Libraries, University of Toledo, Toledo, United States.
FAU - Sharma, Sachit
AU  - Sharma S
AD  - Internal Medicine, University of Toledo, Toledo, United States. RINGGOLD: 7923
FAU - Acharya, Ashu
AU  - Acharya A
AD  - Internal Medicine, University of Toledo, Toledo, United States. RINGGOLD: 7923
FAU - Faggen, Alec E
AU  - Faggen AE
AD  - Gastroenterology, University of California San Francisco, San Francisco, United 
      States. RINGGOLD: 8785
FAU - Farooq, Umer
AU  - Farooq U
AUID- ORCID: 0000-0001-8272-0172
AD  - Department of Medicine, Loyola Medicine/MacNeal Hospital, Berwyn, United States.
FAU - Tarar, Zahid I
AU  - Tarar ZI
AD  - Internal Medicine, University of Missouri School of Medicine, Columbia, United 
      States. RINGGOLD: 12271
FAU - Aziz, Muhammad
AU  - Aziz M
AD  - Internal Medicine, University of Toledo, Toledo, United States. RINGGOLD: 7923
FAU - Baron, Todd
AU  - Baron T
AD  - Gastroenterology & Hepatology, University of North Carolina, Chapel Hill, United 
      States.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20230904
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC10477022
OTO - NOTNLM
OT  - Endoscopic ultrasonography
OT  - Intervention EUS
OT  - Pancreas
COIS- Conflict of Interest Dr. Todd Baron is a speaker and consultant for Boston 
      Scientific, Cook Endoscopy, W.L. Gore and CONMED. Other authors have no relevant 
      conflicts of interest.
EDAT- 2023/09/06 06:42
MHDA- 2023/09/06 06:43
PMCR- 2023/09/01
CRDT- 2023/09/06 03:51
PHST- 2022/02/28 00:00 [received]
PHST- 2023/05/17 00:00 [accepted]
PHST- 2023/09/06 06:43 [medline]
PHST- 2023/09/06 06:42 [pubmed]
PHST- 2023/09/06 03:51 [entrez]
PHST- 2023/09/01 00:00 [pmc-release]
AID - EIO-2022-02-2694-REV [pii]
AID - 10.1055/a-2100-9076 [doi]
PST - epublish
SO  - Endosc Int Open. 2023 Sep 4;11(9):E794-E799. doi: 10.1055/a-2100-9076. 
      eCollection 2023 Sep.