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Published on: June 2, 2018
Metal Versus Plastic Stents for Pancreatic Fluid Collection Drainage: A Systematic Review and Meta-analysis
Xianzhu Zhou1, Han Lin1, Xiaoju Su1
1Department of Gastroenterology, Changhai Hospital.
Objectives:
The therapeutic efficacy of metal stents (MSs) for pancreatic fluid collections (PFCs) is invariably controversial. Here, we conducted a meta-analysis to summarize the results of efficacy of MSs and plastic stents (PSs) in PFC drainage.
Subjects And Methods:
We performed a literature search of PubMed/MEDLINE, EMBASE, and COCHRANE for all of the published studies regarding the use of MSs and PSs for endoscopic transmural drainage of PFCs from January, 1 2015 to June 1, 2020. We extracted data from 9 studies (1359 patients) that met the inclusion criteria. The main outcome measures were the rates of treatment success, including technique success and clinical success (CS), adverse events, recurrence, procedure time, and length of hospital stay (LOS).
Results:
There was no difference in overall technique success between patients treated with MSs and PSs for PFCs. However, MSs showed a higher CS rate 92% versus 82% (P<0.01) and a lower overall adverse event rate 20% versus 31% (P<0.01) than PSs. The recurrence rate of PFCs using MSs also had significant advantages over PSs 3% versus 10% (P<0.01) and MSs needed a shorter procedure time than PSs (26.73 vs. 45.40 min, P<0.01). In comparing direct endoscopic necrosectomy use and LOS, there was no difference between MSs and PSs.
Conclusions:
Bringing together the results of the current study, endoscopic ultrasound-guided drainage of PFCs using MSs may be superior to PSs in terms of CS, adverse events rates and recurrence rate, with similar LOS and direct endoscopic necrosectomy use.
Insights
Metal stents (MSs) show higher clinical success and lower adverse event rates for pancreatic fluid collections (PFCs) compared to plastic stents (PSs). MSs also reduce recurrence and procedure time, offering a potentially superior option for PFC drainage.
Area of Science:
- Gastroenterology
- Endoscopic Procedures
- Medical Device Technology
Background:
- Pancreatic fluid collections (PFCs) pose therapeutic challenges.
- The efficacy of metal stents (MSs) versus plastic stents (PSs) for PFC drainage remains debated.
- Endoscopic transmural drainage is a key treatment modality.
Purpose of the Study:
- To compare the therapeutic efficacy of metal stents (MSs) and plastic stents (PSs) for pancreatic fluid collections (PFCs).
- To summarize outcomes including treatment success, adverse events, and recurrence rates.
Main Methods:
- A meta-analysis was conducted on studies published between January 2015 and June 2020.
- Literature search included PubMed/MEDLINE, EMBASE, and COCHRANE databases.
- Data from 9 studies involving 1359 patients were analyzed for technique success, clinical success (CS), adverse events, recurrence, procedure time, and length of hospital stay (LOS).
Main Results:
- No significant difference in overall technique success between MSs and PSs.
- MSs demonstrated a higher clinical success (CS) rate (92% vs. 82%) and lower adverse event rates (20% vs. 31%) compared to PSs.
- MSs showed significantly lower recurrence rates (3% vs. 10%) and shorter procedure times (26.73 min vs. 45.40 min) than PSs.
Conclusions:
- Endoscopic ultrasound-guided drainage of PFCs using MSs appears superior to PSs.
- MSs offer advantages in clinical success, reduced adverse events, and lower recurrence rates.
- Similar length of hospital stay and direct endoscopic necrosectomy use were observed between stent types.
