EUS-guided Drainage of Pancreatic Fluid Collections Using Lumen Apposing Metal Stents With or Without Coaxial Plastic Stents: A Systematic Review and Meta-analysis.

Authors

• Faisal Kamal
• Muhammad Ali Khan
• Wade Lee-Smith
• Sachit Sharma
• Ashu Acharya
• Umer Farooq
• Manesh Kumar Gangwani
• Aamir Saeed
• Muhammad Aziz
• Umar Hayat
• Nasir Saleem
• Anand Kumar
• Alexander Schlachterman
• Thomas Kowalski

Publication/Presentation Date

1-1-2025

Abstract

BACKGROUND AND AIMS: Co-axial plastic double pigtail stents (DPSs) are commonly placed through lumen apposing metal stents (LAMS) in patients with pancreatic fluid collections (PFCs) to decrease the risk of adverse events. In this meta-analysis, we have compared the outcomes of LAMS plus co-axial DPS versus LAMS alone in patients with PFCs.

METHODS: We reviewed several databases to identify the studies that compared outcomes of LAMS with DPS to LAMS without DPS in the treatment of PFCs. Our outcomes of interest were overall adverse events, clinical success and individual adverse events such as stent (LAMS) migration, stent occlusion, bleeding, and infection. We calculated pooled risk ratios (RR) with 95% confidence intervals (CIs) for the analysis of outcomes. We used a random effects model to analyze the data. Heterogeneity was assessed using the I 2 statistic.

RESULTS: We included 10 studies with 685 patients. Rate of overall adverse events was significantly lower in the LAMS+DPS group compared with LAMS alone, RR (95% CI) 0.58 (0.40, 0.87). There was no significant difference in the rate of clinical success between groups, RR (95% CI) 1.03 (0.94, 1.13). We found no significant difference in rate of stent occlusion between groups. Rate of infection was significantly lower in LAMS+DPS group, RR (95% CI) 0.46 (0.24, 0.85). There was no significant difference in rate of bleeding and stent (LAMS) migration between groups.

CONCLUSIONS: Addition of co-axial DPS to LAMS decreases the risk of adverse events in patients with PFCs and should be considered in all patients with PFCs.

Volume

59

Issue

1

First Page

47

Last Page

53

ISSN

1539-2031

Published In/Presented At

Kamal, F., Khan, M. A., Lee-Smith, W., Sharma, S., Acharya, A., Farooq, U., Gangwani, M. K., Saeed, A., Aziz, M., Hayat, U., Saleem, N., Kumar, A., Schlachterman, A., & Kowalski, T. (2025). EUS-guided Drainage of Pancreatic Fluid Collections Using Lumen Apposing Metal Stents With or Without Coaxial Plastic Stents: A Systematic Review and Meta-analysis. Journal of clinical gastroenterology, 59(1), 47–53. https://doi.org/10.1097/MCG.0000000000002080

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

39404654

Department(s)

Administration and Leadership

Document Type

Article