Metal Versus Plastic for Pancreatic Pseudocyst Drainage: Clinical Outcomes and Success

Endoscopic versus surgical treatment for pancreatic pseudocyst

“…A retrospective cohort study by Sharaiha et al demonstrated that the use of fully covered self-expanding metal stents (FCSEMS) instead of plastic stents could increase the complete resolution rate of pancreatic pseudocyst and significantly decrease the procedural adverse events. 23 The recurrence rate of the endoscopic group in this metaanalysis was 3.1%, which was comparable to the 5% reported by Varadarajulu et al in a large case-series study including 211 participants. 24 Disconnected duct syndrome has been considered a major factor leading to pseudocyst recurrence.…”

Lumen‐apposing metal stents for drainage of pancreatic fluid collections: When and for whom?

“…16 However, in a recent retrospective, comparative study, better treatment outcomes were observed with fully covered metal stents. 17 Differences in treatment outcomes between the two studies may be explained by the significant heterogeneity in the data as a result of inclusion of unmatched patients in the previous study and the type of metal endoprostheses that were used. Although it is logical to assume that larger-caliber metal stents will provide better drainage of necrotic contents and improve treatment outcomes, as with pseudocysts, we did not observe any difference, which is in line with a systematic review that demonstrated pooled treatment success rates of 70% and 78% (no significant difference) for the plastic and metal stent cohorts, respectively, 16 as well as a recently published comparative study.…”

Comparative efficacy of stents in endoscopic ultrasonography‐guided peripancreatic fluid collection drainage: A systematic review and network meta‐analysis

“…Among them, two were designed as a three‐arm study that compared efficacy among LAMS, DPPS, and FCSEMS . All other studies were two‐arm study designs comparing LAMS versus DPPS, LAMS versus FCSEMS, and DPPS versus FCSEMS . The available direct evidence and network of included studies are shown in Figure S1.…”

“…The included studies had been published between 2014 and 2019, with an enrollment period that ranged from 2005 to 2017 (Table ) . Among them, two were designed as a three‐arm study that compared efficacy among LAMS, DPPS, and FCSEMS .…”

“…Two RCTs were assessed as having a low risk of bias for all domains, including random sequence generation, allocation concealment, blinding of participants and personnel, blinding of outcome assessment, incomplete outcome data, selective reporting, and other bias. Among the 13 retrospective cohort studies, 7 (54%) were rated as being of high quality …”