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. 2019 May 14:12:2631774519843400.
doi: 10.1177/2631774519843400. eCollection 2019 Jan-Dec.

Comparative outcomes of endoscopic ultrasound-guided cystogastrostomy for peripancreatic fluid collections: a systematic review and meta-analysis

Benjamin D Renelus  1 , Daniel S Jamorabo  1 , Hashroop K Gurm  2 , Niel Dave  2 , William M Briggs  3 , Mukul Arya  1
Affiliations

Comparative outcomes of endoscopic ultrasound-guided cystogastrostomy for peripancreatic fluid collections: a systematic review and meta-analysis

Benjamin D Renelus et al. Ther Adv Gastrointest Endosc. .

Abstract

Background: Endoscopic ultrasound-guided cystogastrostomy has become the first-line treatment for symptomatic peripancreatic fluid collections. The aim of this study is to analyze the efficacy and safety of cystogastrostomy via a meta-analysis of the literature.

Methods: We performed a systematic search of PubMed and Medline databases for studies published from January 2005 to May 2018. We included randomized controlled trials along with retrospective and prospective observational studies reporting endoscopic ultrasound-guided cystogastrostomy stent placement for peripancreatic fluid collections. The primary outcome for our meta-analysis was complete peripancreatic fluid collection resolution on imaging. Our secondary outcomes included comparative efficacy and safety of the procedure for pseudocysts and walled-off pancreatic necrosis using metal and plastic stents.

Results: Seventeen articles involving 1708 patients met our inclusion criteria for meta-analysis. Based upon the random effects model, the pooled technical success rate of cystogastrostomy was 88% (95% confidence interval = 83-92 with I 2 = 85%). There was no difference in the technical success rate between pancreatic pseudocysts and walled-off pancreatic necrosis (91% and 86%, respectively p = nonsignificant). The adverse event rates for metal and plastic stents were equivalent (14% and 18%, respectively, p = nonsignificant).

Conclusion: Endoscopic ultrasound-guided cystogastrostomy stents are effective in the treatment of pancreatic pseudocysts and walled-off pancreatic necrosis. We found no difference in technical success or adverse event rates of drainage based on peripancreatic fluid collection type or stent used.

Keywords: advanced endoscopy; cystogastrostomy; peripancreatic fluid collection.

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Conflict of interest statement

Conflict of interest statement: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
PRISMA diagram.
Figure 2.
Figure 2.
Pooled overall efficacy for cystogastrostomy in PPs and WOPN.
Figure 3.
Figure 3.
Pooled efficacy for cystogastrostomy in PPs.
Figure 4.
Figure 4.
Pooled efficacy for cystogastrostomy in WOPN.
Figure 5.
Figure 5.
Cystogastrostomy efficacy for PP by stent type.
Figure 6.
Figure 6.
Cystogastrostomy efficacy for WOPN by stent type.
Figure 7.
Figure 7.
Pooled adverse events for metal stents.
Figure 8.
Figure 8.
Pooled adverse events for plastic stents.
Figure 9.
Figure 9.
Heterogeneity plot.
Figure 10.
Figure 10.
Funnel plot for publication bias.
See this image and copyright information in PMC

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References

    1. Forsmark CE, Swaroop Vege S, et al. Acute pancreatitis. N Eng J Med 2016; 375: 1972–1981. - PubMed
    1. Fagenholz PJ, Castillo CF, Harris NS, et al. Increasing United States hospital admissions for acute pancreatitis, 1988–2003. Ann Epidemiol 2007; 17: 491–497. - PubMed
    1. Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis – 2012: revision of the Atlanta classification and definitions by international consensus. Gut 2013; 62: 102–111. - PubMed
    1. Habashi S, Draganov PV. Pancreatic pseudocyst. World J Gastrointest Endosc 2009; 15: 38–47. - PMC - PubMed
    1. Forsmark CE, Baillie J. AGA Institute technical review on acute pancreatitis. Gastroenterology 2007; 132: 2022–2044. - PubMed

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