Endoscopic versus laparoscopic drainage of pseudocyst and walled-off necrosis following acute pancreatitis: a randomized trial

Garg, Pramod Kumar; Meena, Danishwar; Babu, Divya; Padhan, Rajesh; Dhingra, Rajan; Krishna, Asuri; Kumar, Subodh; Misra, Mahesh Chandra; Bansal, Virinder Kumar

doi:10.1007/s00464-019-06866-z

Cited by 44 publications

(38 citation statements)

References 23 publications

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“…Larg and colleagues compared surgical versus endoscopic cystgastrostomy and necrosectomy. The success rate was 93.3% and 90% in the laparoscopic and endoscopic groups, respectively (25). Overall, the cost, length of hospital stay, and invasiveness is higher with the surgical approach when compared to an endoscopic approach (26).…”

Section: Procedural Considerations For Drainagementioning

confidence: 93%

Management of severe acute pancreatitis in 2019

Copelin¹,

Widmer²

2021

Transl Gastroenterol Hepatol

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shock (systolic blood pressure <90 mmHg), pulmonary insufficiency (PaO 2 ≤60 mmHg), acute kidney injury (serum creatinine level >2 mg/dL), and gastrointestinal bleeding. Approximately 15-25% of all patients with acute pancreatitis develop severe pancreatitis with local complications, such as necrosis, pseudocyst, or abscess formation (2). NutritionPatients who develop pancreatitis are often placed NPO until the inflammation has resolved and can withstand an oral diet. Current ligature supports the notion that enteral nutrition is superior to parenteral nutrition. In severe acute

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Section: Procedural Considerations For Drainagementioning

confidence: 93%

Management of severe acute pancreatitis in 2019

Copelin¹,

Widmer²

2021

Transl Gastroenterol Hepatol

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“…Two randomized controlled trials (RCTs) showed the superior technical success of EUS-guided drainage over conventional endoscopic drainage for pancreatic pseudocysts with similar clinical success and complications. [7][8][9][17][18][19] Preprocedure imaging assesses the maturity of cyst wall, proximity to gut lumen, size of the cyst, necrotic contents within the cyst, presence of pseudoaneurysms, and pancreatic ductal disruption. A contrast-enhanced computed tomography (CECT) or magnetic resonance imaging (MRI) examination is performed for assessing a PFC.…”

Section: Statement 4 Eus-guided Access Is Preferred Over Conventional Endoscopic-guided Accessmentioning

confidence: 99%

Endoscopic Management of Pancreatic Fluid Collections: Guidelines of Society of Gastrointestinal Endoscopy of India and Indian EUS Club

Shah

Basha

Rana

et al. 2021

Journal of Digestive Endoscopy

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“…17 references were full text screened and of these 3 were excluded as one reference presented the trial registry of a non-randomized trial and one reference presented the trial registry of an ongoing trial [24], while one randomized trial identified by hand search presented a trial that excluded patients with > 30% necrotic debris in the walled-off necrosis. Furthermore, 18.3% of the patients in the trial were patients with pseudocysts and the patients with walled-off necrosis had sterile walled-off necrosis [25]. The remaining 14 references were all related to the three included studies (trial registry [26][27][28], congress abstracts or comments [29,34], protocols [35,36], final publications [37][38][39]).…”

Section: Study Selectionmentioning

confidence: 99%

Endoscopic versus surgical treatment for infected necrotizing pancreatitis: a systematic review and meta-analysis of randomized controlled trials

et al. 2020

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Objective To compare outcomes of endoscopic and surgical treatment for infected necrotizing pancreatitis (INP) based on results of randomized controlled trials (RCT). Background Treatment of INP has changed in the last two decades with adoption of interventional, endoscopic and minimally invasive surgical procedures for drainage and necrosectomy. However, this relies mostly on observational studies. Methods We performed a systematic review following Cochrane and PRISMA guidelines and AMSTAR-2 criteria and searched CENTRAL, Medline and Web of Science. Randomized controlled trails that compared an endoscopic treatment to a surgical treatment for patients with infected walled-off necrosis and included one of the main outcomes were eligible for inclusion. The main outcomes were mortality and new onset multiple organ failure. Prospero registration ID: CRD42019126033 Results Three RCTs with 190 patients were included. Intention to treat analysis showed no difference in mortality. However, patients in the endoscopic group had statistically significant lower odds of experiencing new onset multiple organ failure (odds ratio (OR) confidence interval [CI] 0.31 [0.10, 0.98]) and were statistically less likely to suffer from perforations of visceral organs or enterocutaneous fistulae (OR [CI] 0.31 [0.10, 0.93]), and pancreatic fistulae (OR [CI] 0.09 [0.03, 0.28]). Patients with endoscopic treatment had a statistically significant lower mean hospital stay (Mean difference [CI] − 7.86 days [− 14.49, − 1.22]). No differences in bleeding requiring intervention, incisional hernia, exocrine or endocrine insufficiency or ICU stay were apparent. Overall certainty of evidence was moderate. Conclusion There seem to be possible benefits of endoscopic treatment procedure. Given the heterogenous procedures in the surgical group as well as the low amount of randomized evidence, further studies are needed to evaluate the combination of different approaches and appropriate timepoints for interventions.

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Endoscopic versus laparoscopic drainage of pseudocyst and walled-off necrosis following acute pancreatitis: a randomized trial

Cited by 44 publications

References 23 publications

Management of severe acute pancreatitis in 2019

Management of severe acute pancreatitis in 2019

Endoscopic Management of Pancreatic Fluid Collections: Guidelines of Society of Gastrointestinal Endoscopy of India and Indian EUS Club

Endoscopic versus surgical treatment for infected necrotizing pancreatitis: a systematic review and meta-analysis of randomized controlled trials

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