Efficacy and safety of endoscopic ultrasound-guided pancreatic duct drainage (EUS-PDD): A systematic review and meta-analysis of 714 patients.

ABSTRACT: Background and study aims? Endoscopic ultrasound guided pancreatic duct drainage (EUS-PDD) is a minimal-invasive therapeutic option to surgery and in patients with failed endoscopic retrograde pancreatography (ERP). The aim of this review was to quantitatively appraise the clinical outcomes of EUS-PDD by meta-analysis methods. Methods? We searched multiple databases from inception through March 2020 to identify studies that reported on EUS-PDD. Pooled rates of technical success, successful drainage of pancreatic duct, clinical success, and adverse events were calculated. Study heterogeneity was assessed using I 2 % and 95?% prediction interval. Results? A total of 22 studies (714 patients) were included. The pooled rate of technical success in EUS-PDD was 84.8?% (95?% CI 79.1-89.2). The pooled rate of successful PD drained by EUS-PDD was 77.5?% (95?% CI 63.1-87.4). The pooled rate of clinical success of EUS-PDD was 89.2?% (95?% CI 82.1-93.7). The pooled rate of all adverse events was 18.1?% (95?% CI 14.2-22.9). On sub-group analysis, the pooled technical success and clinical success of EUS-PDD from Japanese data were considerably superior (91.2?%, 83-95.6 & 92.5?%, 83.9-96.7, respectively). The pooled rate of post EUS-PDD acute pancreatitis was 6.6?% (95?% CI 4.5-9.4), bleeding was 4.1?% (95?% CI 2.7-6.2), perforation and/or pneumoperitoneum was 3.1?% (95?% CI 1.9-5), pancreatic leak and/or pancreatic fluid collection was 2.3?% (95?% CI 1.4-4), and infection was 2.8?% (95?% CI 1.7-4.6). Conclusion? EUS-PDD demonstrates high technical success and clinical success rates with acceptable adverse events. Technical success was especially high for anastomotic strictures.

SUBMITTER: Chandan S 

PROVIDER: S-EPMC7581476 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature