Coaxial plastic stent placement within lumen-apposing metal stents for the management of pancreatic fluid collections: a systemic review and meta-analysis
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Background/Aims: Coaxial placement of double pigtail plastic stents (DPPS) through lumen-apposing metal stents (LAMSs) is commonly performed to reduce the risk of LAMS obstruction, bleeding, and stent migration when used for the drainage of pancreatic fluid collections (PFCs). A systematic review and meta-analysis were performed to compare the outcomes of LAMS alone and LAMS with coaxial DPPS placement in the management of PFCs. Methods: A systematic review was conducted to identify studies comparing LAMS and LAMS/DPPS for PFC drainage. Primary outcomes included the rate of clinical success, overall adverse events (AEs), bleeding, infection, occlusion, and stent migration. The pooled effect size was summarized using a random-effects model and compared between LAMS and LAMS/DPPS by calculating odds ratios (ORs). Results: Nine studies involving 709 patients were identified (338 on LAMS and 371 on LAMS/DPPS). LAMS/DPPS was associated with a reduced risk of stent obstruction (OR, 0.59; p=0.004) and infection (OR, 0.55; p=0.001). No significant differences were observed in clinical success (OR, 0.96; p=0.440), overall AEs (OR, 0.57; p=0.060), bleeding (OR, 0.61; p=0.120), or stent migration (OR, 1.03; p=0.480). Conclusions: Coaxial DPPS for LAMS drainage of PFCs is associated with a reduced risk of stent occlusion and infection; however, no difference was observed in the overall AE rates or bleeding.
Abstract
Background/Aims: Coaxial placement of double pigtail plastic stents (DPPS) through lumen-apposing metal stents (LAMSs) is commonly performed to reduce the risk of LAMS obstruction, bleeding, and stent migration when used for the drainage of pancreatic fluid collections (PFCs). A systematic review and meta-analysis were performed to compare the outcomes of LAMS alone and LAMS with coaxial DPPS placement in the management of PFCs. Methods: A systematic review was conducted to identify studies comparing LAMS and LAMS/DPPS for PFC drainage. Primary outcomes included the rate of clinical success, overall adverse events (AEs), bleeding, infection, occlusion, and stent migration. The pooled effect size was summarized using a random-effects model and compared between LAMS and LAMS/DPPS by calculating odds ratios (ORs). Results: Nine studies involving 709 patients were identified (338 on LAMS and 371 on LAMS/DPPS). LAMS/DPPS was associated with a reduced risk of stent obstruction (OR, 0.59; p=0.004) and infection (OR, 0.55; p=0.001). No significant differences were observed in clinical success (OR, 0.96; p=0.440), overall AEs (OR, 0.57; p=0.060), bleeding (OR, 0.61; p=0.120), or stent migration (OR, 1.03; p=0.480). Conclusions: Coaxial DPPS for LAMS drainage of PFCs is associated with a reduced risk of stent occlusion and infection; however, no difference was observed in the overall AE rates or bleeding.
참고문헌 (38)
- Baron TH, "American Gastroenterolog ical Association clinical practice update : management of pancreatic necrosis", Gastroenterology, 158, pp.67~75 (2020)
- van Santvoort HC, "A step-up ap proach or open necrosectomy for necrotizing pancreatitis", N Engl J Med, 362, pp.1491~1502 (2010)
- van Brunschot S, "Endoscop ic or surgical step-up approach for infected necrotising pancreatitis : a multicentre randomised trial", Lancet, 391, pp.51~58 (2018)
- Hollemans RA, "Superiority of step-up approach vs open necrosectomy in long-term fol low-up of patients with necrotizing pancreatitis", Gastroenterology, 156, pp.1016~1026 (2019)
- ASGE Standards of Practice Committee, "The role of endoscopy in the diagnosis and treatment of inflammatory pancreatic fluid collections", Gastrointest Endosc, 83, pp.481~488 (2016)
- Keane MG, "Endoscopic versus percutaneous drainage of symptomatic pancreatic fluid collections : a 14year experience from a tertiary hepatobiliary centre", Surg Endosc, 30, pp.3730~3740 (2016)
- Khan MA, "Endoscopic versus percutaneous management for symptomatic pancreatic fluid collections : a systematic review and meta-analysis", Endosc Int Open, 6, pp.E474~E483 (2018)
- Hookey LC, "Endoscopic drainage of pancreatic-fluid collections in 116 patients : a comparison of eti ologies, drainage techniques, and outcomes", Gastrointest Endosc, 63, pp.635~643 (2006)
- Chandrasekhara V, "Predicting the need for step-up therapy after EUS-guided drainage of pancreatic fluid collections with lumen-apposing metal stents", Clin Gastroenterol Hepatol, 19, pp.2192~2198 (2021)
- Park DH, "Endoscopic ultrasound-guided versus conventional transmural drainage for pancreatic pseudocysts : a prospective randomized trial", Endoscopy, 41, pp.842~848 (2009)
- Siddiqui AA, "EUS-guided drainage of peri pancreatic fluid collections and necrosis by using a novel lumen-ap posing stent : a large retrospective, multicenter U. S. experience(with videos)", Gastrointest Endosc, 83, pp.699~707 (2016)
- "AXIOS Stent with Delivery System 510(k) K153088. 20998/S007 approval letter" (2015)[URL]
- Shah RJ, "Safety and efficacy of endoscopic ultrasound-guided drainage of pancreatic fluid collections with lu men-apposing covered self-expanding metal stents", Clin Gastroen terol Hepatol, 13, pp.747~752 (2015)
- Rinninella E, "EUS-guided drainage of pancreatic fluid collections using a novel lumen-apposing metal stent on an electrocautery-enhanced delivery system : a large retro spective study(with video)", Gastrointest Endosc, 82, pp.1039~1046 (2015)
- Bang JY, "Lumen-apposing metal stents(LAMS)for pancreatic fluid collection(PFC)drainage : may not be business as usual", Gut, 66, pp.2054~2056 (2017)
- Chandrasekhara V, "Safety and efficacy of lumen-apposing metal stents versus plastic stents to treat walled-off pancreatic necrosis : systematic review and meta-analysis", Endosc Int Open, 8, pp.E1639~E1653 (2020)
- "Assess ing cardiovascular risk: systematic evidence review from the Risk Assessment Work Group" (2013)[URL]
- Higgins JP, "The Cochrane Collab oration’s tool for assessing risk of bias in randomised trials", BMJ, 343, pp.d5928~ (2011)
- AbiMansour JP, "Lumen-apposing metal stents with or without coaxial plastic stent placement for the management of pancreatic fluid collections", Gastrointest Endosc, 99, pp.104~107 (2024)
- Puga M, "Safety of lumen-apposing stent with or without coaxial plastic stent for endoscopic ultra sound-guided drainage of pancreatic fluid collections : a retrospec tive study", Endoscopy, 50, pp.1022~1026 (2018)
- Aburajab M, "Safety and efficacy of lumen-ap posing metal stents with and without simultaneous double-pigtail plastic stents for draining pancreatic pseudocyst", Gastrointest En dosc, 87, pp.1248~1255 (2018)
- Ali SE, "Anchoring lumen-appos ing metal stent with coaxial plastic stent for endoscopic ultra sound-guided drainage of pancreatic fluid collections : any benefit?", Ann Gastroenterol, 32, pp.620~625 (2019)
- Haddad JD, "Safety and efficacy of lu men-apposing metal stents with and without coaxial plastic stents for pancreatic fluid collections", Tech Innov Gastrointest Endosc, 25, pp.113~118 (2023)
- Shamah SP, "Double pigtail stent placement as an adjunct to lumen-apposing metal stentsfor drainage of pancreatic fluid collections may not affect outcomes : a multicenter experience", Endosc Ultrasound, 11, pp.53~58 (2022)
- Vanek P, "EUS-guided transluminal drainage using lumen-apposing metal stents with or without coaxial plastic stents for treatment of walled-off necrotizing pancreatitis : a pro spective bicentric randomized controlled trial", Gastrointest Endosc, 97, pp.1070~1080 (2023)
- Aujla P, "Stent within a stent : when lumen apposing metal stent meets its match in coaxial double pigtail stent", Gastrointest Endosc, 97, pp.AB920~ (2023)
- Perez Estrada C, "Efficacy and safety of lumen-apposing metal stents in endoscopic ultrasound-guided drainage of abdom inal fluid collections and the influence of inserting a coaxial dou ble pigtail plastic stent", United Eur Gastroenterol J, 10(Suppl 8), pp.984~985 (2022)
- Gluck M, "Dual modality drainage for symp tomatic walled-off pancreatic necrosis reduces length of hospitaliza tion, radiological procedures, and number of endoscopies compared to standard percutaneous drainage", J Gastrointest Surg, 16, pp.248257~ (2012)
- Varadarajulu S, "Multiple translu minal gateway technique for EUS-guided drainage of symptomatic walled-off pancreatic necrosis", Gastrointest Endosc, 74, pp.74~80 (2011)
- Bakker OJ, "Endoscopic transgastric vs surgical necrosectomy for infected necrotizing pan creatitis : a randomized trial", JAMA, 307, pp.1053~1061 (2012)
- Varadarajulu S, "Equal efficacy of endoscop ic and surgical cystogastrostomy for pancreatic pseudocyst drainage in a randomized trial", Gastroenterology, 145, pp.583~590 (2013)
- Penn DE, "Prospective evaluation of the use of fully covered self-expanding metal stents for EUS-guided transmural drainage of pancreatic pseudocysts", Gastrointest Endosc, 76, pp.679~684 (2012)
- Bang JY, "Importance of discon nected pancreatic duct syndrome in recurrence of pancreatic fluid collections initially drained using lumen-apposing metal stents", Clin Gastroenterol Hepatol, 19, pp.1275~1281 (2021)
- van Dijk SM, "Treatment of dis rupted and disconnected pancreatic duct in necrotizing pancreatitis : a systematic review and meta-analysis", Pancreatology, 19, pp.905915~ (2019)
- Wang L, "Impact of disconnected pancre atic duct syndrome on endoscopic ultrasound-guided drainage of pancreatic fluid collections", Endoscopy, 53, pp.603~610 (2021)
- Giri S, "Does a coaxial double pigtail stent reduce adverse events after lumen apposing met al stent placement for pancreatic fluid collections? A systematic review and meta-analysis", Ther Adv Gastrointest Endosc, 16, pp.26317745231199364~ (2023)
- Lang GD, "EUS-guided drainage of peripancre atic fluid collections with lumen-apposing metal stents and plastic double-pigtail stents : comparison of efficacy and adverse event rates", Gastrointest Endosc, 87, pp.150~157 (2018)
- Dayyeh BK, "Combined drainage and protocolized necrosectomy through a coaxial lumen-apposing metal stent for pancreatic walled-off necrosis : a prospective multi center trial", Ann Surg, 277, pp.e1072~e1080 (2023)