Early versus delayed EUS-guided drainage for postoperative pancreatic fluid collections: a systematic review and meta-analysis
Year: 2023
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: BACKGROUND: Postoperative pancreatic fluid collections (POPFCs) are common adverse events (AEs) after pancreatic surgery and may need interventions. Endoscopic ultrasound (EUS)-guided drainage for POPFCs is increasingly reported, but its appropriate timing has not been fully elucidated. The aim of this meta-analysis was to evaluate treatment outcomes of POPFCs according to the timing of EUS-guided drainage. METHODS: Using PubMed, Embase, Web of Science, and the Cochrane database, we identified clinical studies published until December 2022 with data comparing outcomes of early and delayed EUS-guided drainage for POPFCs. We pooled data on AEs, mortality, and technical and clinical success rates, using the random-effects model. RESULTS: From 1415 papers identified in the initial literature search, we identified 6 retrospective studies, including 128 and 107 patients undergoing early and delayed EUS-guided drainage for POPFCs. The threshold of early and delayed drainage ranged from 14 to 30 days. Distal pancreatectomy was the major cause of POPFCs, ranging from 44 to 100%. The pooled odds ratio (OR) for AEs was 0.81 (95% confidence interval [CI] 0.40-1.64, P = 0.55) comparing early to delayed drainage. There was no procedure-related mortality. Technical success was achieved in all cases and a pooled OR of clinical success was 0.60 (95% CI 0.20-1.83, P = 0.37). CONCLUSION: POPFCs can be managed by early EUS-guided drainage without an increase in AEs.
Source: Surgical Endoscopy
Authors: Tsuyoshi Mukai, Yousuke Nakai, Tsuyoshi Hamada, Saburo Matsubara, Takashi Sasaki, Hirotoshi Ishiwatari, Susumu Hijioka, Hideyuki Shiomi, Mamoru Takenaka, Takuji Iwashita, Atsuhiro Masuda, Tomotaka Saito, Hiroyuki Isayama, Ichiro Yasuda, for the WONDERFUL Study Group in Japan, Tatsuya Sato, Keito Nakagawa, Kentaro Suda, Ryota Nakano, Shogo Ota, Kotaro Takeshita, Shunsuke Omoto, Senju Akihiko, Ryuichi Tezuka, Shinya Uemura, Masahiro Tsujimae, Arata Sakai, Mitsuru Okuno, Yuhei Iwasa, Keisuke Iwata, Kensaku Yoshida, Akinori Maruta, Toshio Fujisawa, Sho Takahashi, Nobuhiko Hayashi
Institutions: Kanazawa Medical University, University of Tokyo Hospital, The University of Tokyo, The Cancer Institute Hospital, Japanese Foundation For Cancer Research, Saitama Medical Center, Saitama Medical University, Shizuoka Cancer Center, National Cancer Centre Japan, Hyogo Medical University, Kindai University, Gifu University Hospital, Kobe University, Juntendo University, University of Toyama, Gifu Municipal Hospital
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,190
OpenAlex ID: W4389080423