TY - JOUR
T1 - Disconnected pancreatic duct syndrome and outcomes of endoscopic ultrasound-guided treatment of pancreatic fluid collections
T2 - Systematic review and meta-analysis
AU - for the WONDERFUL study group in Japan
AU - Hamada, Tsuyoshi
AU - Iwashita, Takuji
AU - Saito, Tomotaka
AU - Shiomi, Hideyuki
AU - Takenaka, Mamoru
AU - Isayama, Hiroyuki
AU - Yasuda, Ichiro
AU - Nakai, Yousuke
N1 - Publisher Copyright:
© 2021 Japan Gastroenterological Endoscopy Society.
PY - 2022/5
Y1 - 2022/5
N2 - Background: Disconnected pancreatic duct syndrome (DPDS) frequently occurs in patients with acute necrotizing pancreatitis and resultant pancreatic fluid collection (PFC). We performed a systematic review and meta-analysis to evaluate outcomes of endoscopic ultrasound-guided treatment of PFCs according to the presence of DPDS. Methods: Using PubMed, Embase, and the Cochrane database, we identified clinical studies published until January 2021 with data comparing outcomes of endoscopic ultrasound-guided drainage of PFCs between DPDS and non-DPDS patients. We pooled data on technical and clinical success rates, PFC recurrence, and adverse events using the random-effects model. Results: We identified five eligible articles including 941 PFC patients treated with endoscopic ultrasound-guided interventions. Clinical success, defined as resolution of the PFC and symptoms, was achieved in a majority of the cases irrespective of DPDS (pooled odds ratio [OR] comparing DPDS to non-DPDS patients, 0.77; 95% confidence interval [CI] 0.33–1.81). Compared to patients without DPDS, patients with DPDS were more likely to undergo PFC recurrence (pooled OR 6.72; 95% CI 2.72–16.6) after clinical resolution of PFC. Prolonged plastic stent placement following the clinical resolution was more frequently performed in DPDS patients than in non-DPDS patients (pooled OR 15.9; 95% CI 2.76–91.9). No statistically significant difference was observed between the groups in terms of the rate of technical success, adverse events, or mortality. Conclusion: Disconnected pancreatic duct syndrome was associated with higher rate of PFC recurrence after successful endoscopic treatment of PFCs. Future studies should evaluate effectiveness and optimal duration of long-term placement of transmural plastic stents for PFCs with DPDS.
AB - Background: Disconnected pancreatic duct syndrome (DPDS) frequently occurs in patients with acute necrotizing pancreatitis and resultant pancreatic fluid collection (PFC). We performed a systematic review and meta-analysis to evaluate outcomes of endoscopic ultrasound-guided treatment of PFCs according to the presence of DPDS. Methods: Using PubMed, Embase, and the Cochrane database, we identified clinical studies published until January 2021 with data comparing outcomes of endoscopic ultrasound-guided drainage of PFCs between DPDS and non-DPDS patients. We pooled data on technical and clinical success rates, PFC recurrence, and adverse events using the random-effects model. Results: We identified five eligible articles including 941 PFC patients treated with endoscopic ultrasound-guided interventions. Clinical success, defined as resolution of the PFC and symptoms, was achieved in a majority of the cases irrespective of DPDS (pooled odds ratio [OR] comparing DPDS to non-DPDS patients, 0.77; 95% confidence interval [CI] 0.33–1.81). Compared to patients without DPDS, patients with DPDS were more likely to undergo PFC recurrence (pooled OR 6.72; 95% CI 2.72–16.6) after clinical resolution of PFC. Prolonged plastic stent placement following the clinical resolution was more frequently performed in DPDS patients than in non-DPDS patients (pooled OR 15.9; 95% CI 2.76–91.9). No statistically significant difference was observed between the groups in terms of the rate of technical success, adverse events, or mortality. Conclusion: Disconnected pancreatic duct syndrome was associated with higher rate of PFC recurrence after successful endoscopic treatment of PFCs. Future studies should evaluate effectiveness and optimal duration of long-term placement of transmural plastic stents for PFCs with DPDS.
KW - endosonography
KW - necrotizing pancreatitis
KW - pancreatic fluid collections
KW - pancreatic pseudocyst
KW - stents
UR - http://www.scopus.com/inward/record.url?scp=85117085421&partnerID=8YFLogxK
U2 - 10.1111/den.14142
DO - 10.1111/den.14142
M3 - 総説
C2 - 34544204
AN - SCOPUS:85117085421
SN - 0915-5635
VL - 34
SP - 676
EP - 686
JO - Digestive Endoscopy
JF - Digestive Endoscopy
IS - 4
ER -