Endoscopy 2023; 55(S 02): S82-S83
DOI: 10.1055/s-0043-1765192
Abstracts | ESGE Days 2023
Oral presentation
EUS guided treatment of pancreatic collections 21/04/2023, 15:30 – 16:30 Liffey Meeting Room 1

Treatment of infected necrotizing pancreatitis using lumen-apposing metal stent (lams) versus plastic stents: meta-analysis of randomized trials

J. Y. Bang
1   Orlando Health Digestive Health Institute, Orlando, United States of America
,
U. Navaneethan
1   Orlando Health Digestive Health Institute, Orlando, United States of America
,
R. Hawes
1   Orlando Health Digestive Health Institute, Orlando, United States of America
,
C. M. Wilcox
1   Orlando Health Digestive Health Institute, Orlando, United States of America
,
S. Varadarajulu
1   Orlando Health Digestive Health Institute, Orlando, United States of America
› Author Affiliations
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Aims There are conflicting data from retrospective studies on comparative efficacy of LAMS and plastic stents in endoscopic management of necrotizing pancreatitis. This meta-analysis compared clinical outcomes of patients treated using either approach in randomized trials.

Methods MEDLINE/EMBASE databases were searched to identify all randomized trials that compared LAMS and plastic stents for treatment of necrotizing pancreatitis. Main outcome measure was to treatment success at 6-month follow-up.

Results Three randomized trials (USA and Europe, n=206) met inclusion criteria. Except for procedural duration, which was significantly shorter for LAMS (SMD-1.22, 95%CI, -1.64 to -0.79, p<0.001), there was no significant difference in tx success (93.3vs.94.9%, RR0.99, p=0.63), no. of interventions (SMD-0.094, 95%CI, -0.40 to 0.22, p=0.55), need for necrosectomy (36.9vs.41.2%, RR0.98, p=0.93), new onset organ failure (10.6vs.14.6%, RR 0.72, p=0.67), mortality (8.5vs.9.8%, RR0.70, p=0.42), bleeding (11.0vs.10.7%, RR1.09, p=0.89), procedure-related AEs (23.6vs.19.2%, RR 1.38, p=0.22), endocrine insufficiency (26.2vs.18.6%, RR1.44, p=0.40), exocrine insufficiency (33.3vs.23.2%, RR1.43, p=0.59), length of hospital stay (SMD-0.062, 95% CI, -0.55 to 0.43, p=0.80), recurrence (4.6vs. 0.60%, RR3.73, p=0.24), readmissions (42.6vs.50.2%, RR0.84, p=0.27), overall costs (SMD-0.094, 95% CI, -0.40 to 0.21, p=0.55) between LAMS and plastic stents, respectively.

Conclusions Except for procedural duration, there is no significant difference in treatment outcomes and overall costs between LAMS and plastic stents. Therefore, LAMS may be preferentially used in sicker patients who cannot undergo prolonged procedures.



Publication History

Article published online:
14 April 2023

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