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A systematic review and meta-analysis of metal versus plastic stents for drainage of pancreatic fluid collections: metal stents are advantageous.
- Source :
- Surgical Endoscopy & Other Interventional Techniques; May2019, Vol. 33 Issue 5, p1412-1425, 14p, 4 Charts, 8 Graphs
- Publication Year :
- 2019
-
Abstract
- <bold>Background: </bold>The 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.<bold>Method: </bold>We 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.<bold>Results: </bold>The 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.<bold>Conclusions: </bold>The 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. [ABSTRACT FROM AUTHOR]
- Subjects :
- PANCREATIC secretions
SURGICAL drainage
SURGICAL stents
CONFIDENCE intervals
ADVERSE health care events
PANCREATIC surgery
RESEARCH
PLASTICS
SECRETION
META-analysis
RESEARCH methodology
SYSTEMATIC reviews
EVALUATION research
MEDICAL cooperation
TREATMENT effectiveness
COMPARATIVE studies
RESEARCH funding
MEDICAL drainage
ODDS ratio
HEMORRHAGE
Subjects
Details
- Language :
- English
- ISSN :
- 18666817
- Volume :
- 33
- Issue :
- 5
- Database :
- Complementary Index
- Journal :
- Surgical Endoscopy & Other Interventional Techniques
- Publication Type :
- Academic Journal
- Accession number :
- 136068440
- Full Text :
- https://doi.org/10.1007/s00464-018-6416-5