Minimally invasive surgery compared to endoscopic intervention for treating infected pancreatic necrosis. A
Guangjiang Wu1, Can Cui1, Qingkun Song2
1Department of Infection Management and Disease Prevention and Control, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Introduction:
The current study aimed to compare the outcomes of endoscopic and minimally invasive surgical treatment for infected necrotizing pancreatitis.
Material And Methods:
A meta-analysis of clinical studies on minimally invasive operations for necrotic infection was conducted. A systematic review and study inclusion were done on multiple databases. English-language prospective comparison studies were included. Random design was used to analyze research with continuous and dichotomous variables.
Results:
Ten studies were included in the current study. When compared to minimally invasive surgery, endoscopic procedures showed significant beneficial outcomes regarding low post-operative complication rates (p = 0.006), new onset organ failure (p < 0.001), and pancreatic fistula (p < 0.001). However, there was no significant difference between the two interventions regarding hospital stay, postoperative bleeding, incisional hernia, endocrine insufficiency, and perforation of a visceral organ.
Conclusions:
Endoscopic therapy appears to have potential advantages over minimally invasive surgery. However, there is no difference between interventions regarding several parameters.
Insights
Endoscopic therapy for infected necrotizing pancreatitis shows better outcomes than minimally invasive surgery, with fewer complications and organ failure. However, hospital stay and other factors were similar between treatments.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Pancreatic Disease Management
Background:
- Infected necrotizing pancreatitis is a severe condition requiring effective treatment.
- Minimally invasive surgical techniques have been explored for managing pancreatic necrosis.
Purpose of the Study:
- To compare the clinical outcomes of endoscopic treatment versus minimally invasive surgery for infected necrotizing pancreatitis.
Main Methods:
- A meta-analysis of ten prospective, English-language comparative studies was performed.
- Systematic review of multiple databases identified relevant clinical studies.
- Random design was employed for analyzing continuous and dichotomous variables.
Main Results:
- Endoscopic procedures demonstrated significantly lower post-operative complication rates (p=0.006).
- Endoscopic therapy resulted in reduced new onset organ failure (p<0.001) and pancreatic fistula (p<0.001).
- No significant differences were observed in hospital stay, bleeding, hernia, endocrine insufficiency, or organ perforation.
Conclusions:
- Endoscopic therapy presents potential advantages over minimally invasive surgery for infected necrotizing pancreatitis.
- Key outcomes like complication rates and organ failure favor endoscopic approaches.
- Intervention choice may depend on specific patient factors and desired outcomes.
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Assessment: