PMID- 37736486
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230923
IS  - 2631-7745 (Electronic)
IS  - 2631-7745 (Linking)
VI  - 16
DP  - 2023 Jan-Dec
TI  - Does a coaxial double pigtail stent reduce adverse events after lumen apposing 
      metal stent placement for pancreatic fluid collections? A systematic review and 
      meta-analysis.
PG  - 26317745231199364
LID - 10.1177/26317745231199364 [doi]
LID - 26317745231199364
AB  - BACKGROUND: Lumen apposing metal stents (LAMSs) have a higher clinical success 
      rate for managing pancreatic fluid collections. But they are associated with 
      adverse events (AEs) like bleeding, migration, buried stent, occlusion, and 
      infection. It has been hypothesized that placing a double pigtail stent (DPS) 
      within LAMS may mitigate these AEs. The present systematic review and 
      meta-analysis were conducted to compare the outcome and AEs associated with LAMS 
      with or without a coaxial DPS (LAMS-DPS). METHODS: A comprehensive literature 
      search of three databases from January 2010 to August 2022 was conducted for 
      studies comparing the outcome and AEs of LAMS alone and LAMS-DPS. Pooled 
      incidence and risk ratios (RRs) with 95% confidence intervals (CIs) were 
      calculated for all the dichotomous outcomes. RESULTS: Overall, eight studies 
      (n = 460) were included in the final analysis. The clinical success rate (RR 
      1.00, 95% CI: 0.87-1.14) and the risk of overall AEs (RR 1.60, 95% CI: 0.95-2.68) 
      remained comparable between both groups. There was no difference in the risk of 
      bleeding between LAMS alone and LAMS-DPS (RR 1.80, 95% CI: 0.83-3.88). Individual 
      analysis of other AEs, including infection, stent migration, occlusion, and 
      reintervention, showed no difference in the risk between both procedures. 
      CONCLUSION: The present meta-analysis shows that coaxial DPS within LAMS may not 
      reduce AE rates or improve clinical outcomes. Further larger studies, including 
      patients with walled-off necrosis, are required to demonstrate the benefit of 
      coaxial DPS within LAMS.
CI  - (c) The Author(s), 2023.
FAU - Giri, Suprabhat
AU  - Giri S
AUID- ORCID: 0000-0002-9626-5243
AD  - Department of Gastroenterology, Nizam's Institute of Medical Sciences, Hyderabad, 
      India.
FAU - Harindranath, Sidharth
AU  - Harindranath S
AD  - Department of Gastroenterology, Seth GS Medical College and KEM Hospital, Mumbai, 
      India.
FAU - Afzalpurkar, Shivaraj
AU  - Afzalpurkar S
AD  - Department of Gastroenterology, Nanjappa Multispecialty Hospital, Davangere, 
      India.
FAU - Angadi, Sumaswi
AU  - Angadi S
AD  - Department of Gastroenterology, Nizam's Institute of Medical Sciences, Hyderabad, 
      India.
AD  - Department of Gastroenterology, Nizam's Institute of Medical Sciences, Hyderabad, 
      India.
FAU - Sundaram, Sridhar
AU  - Sundaram S
AD  - Department of Digestive Diseases and Clinical Nutrition, Tata Memorial Hospital, 
      Homi Bhabha National Institute, Room No. 1004, Homi Bhabha Block, Mumbai, 
      Maharashtra 400012, India.
LA  - eng
PT  - Journal Article
DEP - 20230919
PL  - United States
TA  - Ther Adv Gastrointest Endosc
JT  - Therapeutic advances in gastrointestinal endoscopy
JID - 101741179
PMC - PMC10510348
OTO - NOTNLM
OT  - cystogastrostomy
OT  - lumen apposing metal stents
OT  - meta-analysis
OT  - pancreatic fluid collections
OT  - walled-off necrosis
COIS- The authors declare that there is no conflict of interest.
EDAT- 2023/09/22 06:42
MHDA- 2023/09/22 06:43
PMCR- 2023/09/19
CRDT- 2023/09/22 03:46
PHST- 2023/01/01 00:00 [received]
PHST- 2023/08/10 00:00 [accepted]
PHST- 2023/09/22 06:43 [medline]
PHST- 2023/09/22 06:42 [pubmed]
PHST- 2023/09/22 03:46 [entrez]
PHST- 2023/09/19 00:00 [pmc-release]
AID - 10.1177_26317745231199364 [pii]
AID - 10.1177/26317745231199364 [doi]
PST - epublish
SO  - Ther Adv Gastrointest Endosc. 2023 Sep 19;16:26317745231199364. doi: 
      10.1177/26317745231199364. eCollection 2023 Jan-Dec.