Efficacy and safety of endoscopic drainage versus percutaneous drainage for pancreatic fluid collection; a systematic review and meta-analysis

Hayat Khizar; Huang Zhicheng; Le Chenyu; Wu Yanhua; Yang Jianfeng

doi:10.1080/07853890.2023.2213898

Efficacy and safety of endoscopic drainage versus percutaneous drainage for pancreatic fluid collection; a systematic review and meta-analysis

Ann Med. 2023 Dec;55(1):2213898. doi: 10.1080/07853890.2023.2213898.

Authors

Hayat Khizar^{1

2}, Huang Zhicheng³, Le Chenyu³, Wu Yanhua³, Yang Jianfeng^{2

4

5}

Affiliations

¹ Department of Gastroenterology, International Education College of Zhejiang Chinese Medical University, Hangzhou, China.
² Department of Gastroenterology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of medicine, Hangzhou, China.
³ Department of Gastroenterology, The Fourth School of Clinical Medicine of Zhejiang Chinese Medical University, Hangzhou, China.
⁴ Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, Hangzhou, China.
⁵ Key Laboratory of Integrated Traditional Chinese and Western Medicine for Biliary and Pancreatic Diseases of Zhejiang Province, Hangzhou, China.

Abstract

Background/aims: Pancreatic fluid collections (PFC) are debris or fluid of the pancreas that needs to be drained out. This may result from surgery or necrotizing pancreatitis. This meta-analysis compared the outcomes of PFC through endoscopic and percutaneous interventions.

Methods: A medical database was searched up to June 2022, comparing the outcomes of endoscopic drainage (ED) and percutaneous drainage (PD) for the PFC. Eligible studies reporting clinical and technical success and adverse events were selected.

Results: Seventeen studies with 1170 patients were included for meta-analysis, of which 543 patients underwent ED and 627 underwent PD. The odd ratio (OR) of technical success was 0.81 (95% confidence interval (CI) 0.31, 2.1) and clinical success was in the favor of the ED group at OR 2.23 (95% CI 1.45, 3.41). Adverse events OR 0.62 (95% CI 0.27, 1.39) and stent migration OR 0.61 (95% CI 0.10, 3.88) were the same in both groups, but hospital stay pooled mean difference of 15.02 days (95% CI 9.86, 20.18), mortality OR 0.24 (95% CI 0.09, 0.67), and re-interventions OR 0.25 (95% CI 0.16, 0.40) favored ED.

Conclusions: ED is safe and efficient for PFC with higher clinical success, lower mortality rate, hospital stay, and re-interventions compared with PD.

Keywords: Meta-analysis; Pancreatic fluid collections; endoscopic drainage; infected pancreatic necrosis; percutaneous drainage; post-operative pancreatic drainage.

Publication types

Meta-Analysis
Systematic Review
Review
Research Support, Non-U.S. Gov't

MeSH terms

Drainage / adverse effects
Endoscopy / adverse effects
Humans
Pancreas
Pancreatic Diseases* / surgery
Retrospective Studies
Stents
Treatment Outcome

Grants and funding

This study was supported by grants from the Zhejiang health committee [2021ZH003], the Hangzhou Science and technology commission [202004A14], and the Construction Fund of Medical Key Disciplines of Hangzhou [OO20190001].