Abstract
Options for the endoscopic management of symptomatic pancreatic fluid collections (PFCs) include transmural drainage (TM) alone, transpapillary drainage (TP) alone, or a combination of both drainage method (CD). There have been conflicting reports about the best method. This study performed a meta-analysis to determine whether CD presents an added clinical benefit over TM.
The included studies compared TM with CD and reported clinical success for both methods. A random-effects model was used to determine the pooled odds ratios (ORs) and the 95% confidence intervals (CIs) for the following outcomes: technical success, clinical success, complications, and recurrence.
Nine studies involving a combined total of 604 drainage procedures-373 TMs (62%) and 231 CDs (38%)-were included. CD showed no additional benefit over TM in terms of technical success (OR, 1.12; 95% CI, 0.37-3.37;
=0.85), clinical success (OR, 1.11; 95% CI, 0.65-1.89;
=0.70), recurrence (OR, 1.49; 95% CI, 0.53-4.21;
=0.45), or complications (OR, 1.15; 95% CI, 0.61-2.18;
=0.67).
Pancreatic duct (PD) stenting provides no additional clinical benefit for the TM of PFCs (particularly pseudocysts). Patients undergoing the TM of symptomatic pseudocysts may not require endoscopic retrograde pancreatography (ERP).
