| Background and objective: Pancreatic fluid collections(PFCs)is a common local complication of pancreatic diseases which can cause abdominal pain,gastrointestinal obstruction or intra-abdominal infection.Though endoscopic drainage(ED)and percutaneous catheter drainage(PCD)has emerged as the most common minimally invasive treatments for Pancreatic fluid collections(PFCs),estimates of therapeutic superiority of the two treatments have yielded inconsistent results.In order to settle the disagreement,a Meta-analysis was conducted to compare the efficacy and safety of the two drainages based on clinical evidence.Methods: We retrieved studies consisting of randomized controlled trials(RCTs)and cohort studies that directly compared the efficacy and safety of the two approaches in Pub Med,Embase,Cochrane Library,CNKI and Wanfang database from their inception to September 2020.Primary outcomes of interest were differences in technical success,clinical success and adverse events,and the secondary outcomes were differences in reintervention,the need for surgical intervention,mortality,recurrence and length of hospital stay.Two researchers independently screened,extracted the data.And then,Meta-analysis and assessing risks of bias was carried out using Stata 15.0.Results: A total of 11 cohort studies,representing 297 patients in ED group and 253 in PCD group,were included in the Meta-analysis.There were nonsignificant differences in technical success rate [RR=0.97,95%CI(0.92,1.03),P=0.333],clinical success rate [RR=1.21,95%CI(0.95,1.55),P=0.120],adverse events rate [RR=1.16,95%CI(0.76,1.77),P=0.500],mortality rate [RR=0.82,95%CI(0.35,1.93),P=0.658],and recurrence rate [RR=1.04,95%CI(0.54,1.99),P=0.909] between the two groups.The reintervention rate [RR=0.27,95%CI(0.13,0.57),P=0.001] and the proportion of the need for surgical intervention [RR=0.13,95%CI(0.03,0.51),P=0.004] in ED group were much lower than those in PCD group.The total length of hospital stay [SMD=-0.67,95%CI(-1.01,-0.32),P=0.000] in ED group was shorter,however,there was a nonsignificant difference in the length of post-procedure hospital stay [SMD=-0.76,95%CI(-1.88,0.35),P=0.178] between the two groups.Conclusion: ED is effective for PFCs with the superiority in less reintervention and less surgical need over traditional PCD,despite the similar clinical efficacy and safety,which needs to be identified in more large-sample and high-quality studies. |
