A systematic review and meta-analysis of metal versus plastic stents for drainage of pancreatic fluid collections: metal stents are advantageous
BackgroundThe use of fully covered metal stents (FCSEMS) and specifically designed lumen apposing metal stents for transmural drainage of pancreatic fluid collections has become widespread. A systematic review published in 2015 did not support the routine use of metal stents for drainage of pancreat...
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| Main Authors: | , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2019
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| In: |
Surgical endoscopy and other interventional techniques
Year: 2018, Volume: 33, Issue: 5, Pages: 1412-1425 |
| ISSN: | 1432-2218 |
| DOI: | 10.1007/s00464-018-6416-5 |
| Online Access: | Verlag, Volltext: https://doi.org/10.1007/s00464-018-6416-5
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| Author Notes: | Rebecca Saunders, Jayapal Ramesh, Silvia Cicconi, Jonathan Evans, Vincent S. Yip, Michael Raraty, Paula Ghaneh, Robert Sutton, John P. Neoptolemos, Christopher Halloran |
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| 245 | 1 | 2 | |a A systematic review and meta-analysis of metal versus plastic stents for drainage of pancreatic fluid collections |b metal stents are advantageous |c Rebecca Saunders, Jayapal Ramesh, Silvia Cicconi, Jonathan Evans, Vincent S. Yip, Michael Raraty, Paula Ghaneh, Robert Sutton, John P. Neoptolemos, Christopher Halloran |
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| 520 | |a BackgroundThe use of fully covered metal stents (FCSEMS) and specifically designed lumen apposing metal stents for transmural drainage of pancreatic fluid collections has become widespread. A systematic review published in 2015 did not support the routine use of metal stents for drainage of pancreatic fluid collections. However, recent studies have shown conflicting data; therefore a systematic review and meta-analysis was performed.MethodWe conducted a database search for original comparative studies between plastic and metal stents. The random effects model was used to calculate pooled risk ratios (RR) with 95% confidence intervals (CI). Outcomes analysed were clinical success, adverse events and requirement of further intervention.ResultsThe search identified 936 studies, 7 studies with 681 (340 metal, 341 plastic) patients met inclusion criteria and were included in the meta-analysis. Clinical success was achieved in 93.8% versus 86.2% in the metal and plastic groups, respectively, RR 1.08 [95% CI 1.02-1.14]; p = 0.009. Adverse events were reduced for metal stents when compared with plastic (10.2% vs. 25.0%), RR 0.42 [95% CI 0.22-0.81]; p = 0.010. Metal stent usage reduced bleeding (2.8% vs. 7.9%), RR 0.37; [95% CI 0.18-0.75]; p = 0.006. Further intervention was required in 12.4% of patients in the metal stent group versus 26.7% for plastic stents, RR 0.54; [95% CI 0.22-1.29]; p = 0.165.ConclusionsThe use of metal stents for drainage of pancreatic fluid collections is associated with improved clinical success, fewer adverse events and reduced bleeding compared to plastic stents. | ||
| 534 | |c 2018 | ||
| 650 | 4 | |a Drainage | |
| 650 | 4 | |a Endoscopic ultrasound intervention | |
| 650 | 4 | |a Metal stents | |
| 650 | 4 | |a Pancreatic fluid collection | |
| 650 | 4 | |a Pancreatic pseudocyst | |
| 650 | 4 | |a Plastic stents | |
| 700 | 1 | |a Neoptolemos, John P. |e VerfasserIn |0 (DE-588)172283302 |0 (DE-627)697192954 |0 (DE-576)133150879 |4 aut | |
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