PMID- 38509392
OWN - NLM
STAT- Publisher
LR  - 20240321
IS  - 1432-2218 (Electronic)
IS  - 0930-2794 (Linking)
DP  - 2024 Mar 20
TI  - Efficacy and safety of long-term indwelling plastic stents after resolution of 
      pancreatic fluid collections with endoscopic transmural drainage: a systematic 
      review and meta-analysis.
LID - 10.1007/s00464-024-10784-0 [doi]
AB  - BACKGROUND: Pancreatic fluid collections (PFCs) may recur after resolution with 
      endoscopic transmural drainage (ETD) and standard stent removal (SSR). Herein, we 
      compared the efficacy and safety of leaving long-term indwelling plastic stents 
      (LTIS) vs. standard stent removal after PFC resolution with ETD. METHODS: We 
      performed a systematic review of MEDLINE, EMBASE, CINAHL, Scopus, and Cochrane 
      databases from inception to September 2022. Full-text articles comparing 
      long-term (> 6 months) outcomes of LTIS and SSR were eligible, as well as 
      single-arm studies with >/= 10 patients with LTIS. Two independent reviewers 
      selected studies, extracted data, and assessed the risk of bias using the 
      Newcastle-Ottawa Scale. Measured outcomes included the following: (A) PFC 
      recurrence; (B) interventions for PFC recurrence; (C) technical success; and (D) 
      adverse events (AEs). Meta-analysis was carried out using random-effects models. 
      RESULTS: We included 16 studies, encompassing 1285 patients. Compared to SSR 
      after PFC resolution with ETD, LTIS was associated with significantly lower risk 
      of PFC recurrence (3% vs. 23%; OR 0.22 [95%CI 0.09-0.52]; I(2) = 45%) and need 
      for interventions (2% vs. 14%; OR 0.35 [95%CI 0.16-0.78]; I(2) = 0%). The 
      superiority of LTIS on reducing PFC recurrence was found with walled-off 
      necrosis, with or without disconnected pancreatic duct, and with placement of >/= 2 
      LTIS. When using LTIS, the pooled proportion of AEs was 8% (95%CI 4-11%) and 
      technical success was 93% (95%CI 86-99%). CONCLUSIONS: Our results show that LTIS 
      after PFC resolution with ETD is feasible, safe, and superior to SSR in reducing 
      the risk of PFC recurrence and need for interventions.
CI  - (c) 2024. The Author(s), under exclusive licence to Springer Science+Business 
      Media, LLC, part of Springer Nature.
FAU - Hawa, Fadi
AU  - Hawa F
AD  - Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, 
      MI, USA.
FAU - Chalhoub, Jean M
AU  - Chalhoub JM
AD  - Division of Gastroenterology and Hepatology, Staten Island University Hospital, 
      Northwell Health, Staten Island, NY, USA.
FAU - Vilela, Ana
AU  - Vilela A
AD  - Department of Internal Medicine, Eastern Virginia Medical School, Norfolk, VA, 
      USA.
FAU - Quingalahua, Elit
AU  - Quingalahua E
AD  - Division of Hematology and Oncology, University of Michigan, Ann Arbor, MI, USA.
FAU - Shannon, Carol
AU  - Shannon C
AD  - Taubman Health Sciences Library, University of Michigan, Ann Arbor, MI, USA.
FAU - Philips, George M
AU  - Philips GM
AD  - Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, 
      MI, USA.
FAU - Kwon, Richard S
AU  - Kwon RS
AD  - Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, 
      MI, USA.
FAU - Wamsteker, Erik-Jan
AU  - Wamsteker EJ
AD  - Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, 
      MI, USA.
FAU - Schulman, Allison R
AU  - Schulman AR
AD  - Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, 
      MI, USA.
FAU - DiMagno, Matthew J
AU  - DiMagno MJ
AD  - Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, 
      MI, USA.
FAU - Machicado, Jorge D
AU  - Machicado JD
AUID- ORCID: 0000-0002-2065-1367
AD  - Division of Gastroenterology and Hepatology, University of Michigan, 1500 E 
      Medical Center Dr, Floor 3 Reception D, Ann Arbor, MI, 48109, USA. 
      machicad@med.umich.edu.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20240320
PL  - Germany
TA  - Surg Endosc
JT  - Surgical endoscopy
JID - 8806653
SB  - IM
OTO - NOTNLM
OT  - Disconnected pancreatic duct
OT  - Pancreatic fluid collection
OT  - Pancreatitis
OT  - Transmural stent
EDAT- 2024/03/21 06:43
MHDA- 2024/03/21 06:43
CRDT- 2024/03/21 00:32
PHST- 2023/10/30 00:00 [received]
PHST- 2024/03/07 00:00 [accepted]
PHST- 2024/03/21 06:43 [medline]
PHST- 2024/03/21 06:43 [pubmed]
PHST- 2024/03/21 00:32 [entrez]
AID - 10.1007/s00464-024-10784-0 [pii]
AID - 10.1007/s00464-024-10784-0 [doi]
PST - aheadofprint
SO  - Surg Endosc. 2024 Mar 20. doi: 10.1007/s00464-024-10784-0.