Comparative outcomes of endoscopic ultrasound-guided lumen-apposing mental stents drainage for pancreatic pseudocysts and walled-off necrosis:Case series and meta-analysis

作     者：Jing Li Qian Zhang Anni Zhou Guiping Zhao Peng Li Li Jing;Zhang Qian;Zhou Anni;Zhao Guiping;Li Peng

作者机构：Department of GastroenterologyBeijing Friendship HospitalCapital Medical UniversityNational Clinical Research Center for Digestive DiseasesBeijing Digestive Disease CenterBeijing Key Laboratory for Precancerous Lesion of Digestive DiseasesBeijing 100050China 

出 版 物：《Chronic Diseases and Translational Medicine》 (慢性疾病与转化医学（英文版）)

年 卷 期：2021年第7卷第3期

页      面：157-168页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

基　　金：This study was supported by National Natural Science Foundation of China(81570507) National Key Research and Development Program of China(2017YFC0113600) 

主　　题：Pancreatic pseudocyst Walled-off necrosis Endoscopic treatment Lumen-apposing metal stents 

摘      要：Background:Endoscopic ultrasound(EUS)-guided transmural drainage for pancreatic fluid collections(PFCs)has become the first-line treatment with quicker recovery and more minor injury compared with surgery and percutaneous *** efficacy of stents implantation and drainage for different PFCs remains controversial,especially lumen-apposing metal stents(LAMS).This study aimed to compare the efficacy and safety of LAMS drainage for pancreatic pseudocysts(PPC)and walled-off necrosis(WON).Methods:A meta-analysis was performed for LAMS drainage for WON and PPC by systematically searching PubMed,Cochrane,and Embase databases from January 2010 to January *** 2017 to 2019,12 patients who were treated with LAMS drainage for PFCs in our medical center were also reviewed and included in this ***:Combining 11 copies of documents with the data from our medical center,a total of 585 patients with PFCs were enrolled in this meta-analysis,including 343 patients with WON and 242 with *** technical success rate in WON is not significantly different from that of PPC(P=0.080.05).The clinical success of LAMS placement was achieved in 99%vs 89%in PPC and WON,respectively(RR=0.92,95%CI:0.86-0.98,P=0.010.05).The further intervention of direct endoscopic necrosectomy was required by 60%of patients in WON *** was no significant difference in the incidence of adverse events,including infection,bleeding,stent migration and stent occlusion,after LAMS placement between WON and ***:Endoscopic ultrasound-guided LAMS for PFCs are feasible,effective with preferable technical and clinical success *** clinical effect of LAMS on PPC is slightly better than that of WON,but its adverse reactions still need to be verified in a large-sample prospective study.