Does a coaxial double pigtail stent reduce adverse events after lumen apposing metal stent placement for pancreatic fluid collections? A systematic review and meta-analysis.

Background: Lumen apposing metal stents (LAMSs) have a higher clinical success rate for managing pancreatic fluid collections. But they are associated with adverse events (AEs) like bleeding, migration, buried stent, occlusion, and infection. It has been hypothesized that placing a double pigtail st...

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Publicado en:Therapeutic Advances in Gastrointestinal Endoscopy pp. 1 - 11
Autores principales: Giri, Suprabhat, Harindranath, Sidharth, Afzalpurkar, Shivaraj, Angadi, Sumaswi, Sundaram, Sridhar
Formato: meta analysis research systematic review tables/charts Journal Article
Publicado: Sage Publications Inc. 9/19/2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 9/19/2023
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      pub: Sage Publications Inc.
      place: Thousand Oaks, California
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        atl: Does a coaxial double pigtail stent reduce adverse events after lumen apposing metal stent placement for pancreatic fluid collections? A systematic review and meta-analysis.
      aug:
        au:
          Giri, Suprabhat
          Harindranath, Sidharth
          Afzalpurkar, Shivaraj
          Angadi, Sumaswi
          Sundaram, Sridhar
        affil: Conceptualization, Department of Gastroenterology, Nizam's Institute of Medical Sciences, Hyderabad, India
      sug:
        subj:
          Pancreatic Pseudocyst Therapy
          Drainage Methods
          Stents Utilization
          Adverse Health Care Event Prevention and Control
          Treatment Outcomes
          Human
          Male
          Female
          Systematic Review
          Meta Analysis
          Medline
          Embase
          Confidence Intervals
          Descriptive Statistics
          Male
          Female
      ab: Background: Lumen apposing metal stents (LAMSs) have a higher clinical success rate for managing pancreatic fluid collections. But they are associated with adverse events (AEs) like bleeding, migration, buried stent, occlusion, and infection. It has been hypothesized that placing a double pigtail stent (DPS) within LAMS may mitigate these AEs. The present systematic review and meta-analysis were conducted to compare the outcome and AEs associated with LAMS with or without a coaxial DPS (LAMS-DPS). Methods: A comprehensive literature search of three databases from January 2010 to August 2022 was conducted for studies comparing the outcome and AEs of LAMS alone and LAMS-DPS. Pooled incidence and risk ratios (RRs) with 95% confidence intervals (CIs) were calculated for all the dichotomous outcomes. Results: Overall, eight studies (n = 460) were included in the final analysis. The clinical success rate (RR 1.00, 95% CI: 0.87–1.14) and the risk of overall AEs (RR 1.60, 95% CI: 0.95–2.68) remained comparable between both groups. There was no difference in the risk of bleeding between LAMS alone and LAMS-DPS (RR 1.80, 95% CI: 0.83–3.88). Individual analysis of other AEs, including infection, stent migration, occlusion, and reintervention, showed no difference in the risk between both procedures. Conclusion: The present meta-analysis shows that coaxial DPS within LAMS may not reduce AE rates or improve clinical outcomes. Further larger studies, including patients with walled-off necrosis, are required to demonstrate the benefit of coaxial DPS within LAMS.
      pubtype: Academic Journal
      doctype:
        meta analysis
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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