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内镜治疗与手术治疗胰腺假性囊肿的对比

Endoscopic versus surgical treatment for pancreatic pseudocyst.

作者信息

Zhao Xin, Feng Tao, Ji Wu

机构信息

Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.

出版信息

Dig Endosc. 2016 Jan;28(1):83-91. doi: 10.1111/den.12542. Epub 2015 Oct 20.

Abstract

BACKGROUND AND AIM

To evaluate the effectiveness and safety of endoscopic treatment for pancreatic pseudocyst compared with surgical treatment.

METHODS

PubMed and The Cochrane Library were systematically searched to identify all comparative trials investigating endoscopic versus surgical treatment for pancreatic pseudocyst. Main outcome measures included treatment success rate, adverse events, recurrence rate, length of hospital stay and hospital cost.

RESULTS

Five comparative studies with 255 participants were included in this meta-analysis. The surgical group exhibited a higher treatment success rate than the endoscopic group (OR, 0.43; 95% CI, 0.20-0.95; P = 0.04). However, there was no difference in the rates of adverse events (OR, 0.67; 95% CI, 0.33-1.36; P = 0.27) or recurrence (OR, 1.53; 95% CI, 0.37-6.39; P = 0.56) between the endoscopic and the surgical groups. Evidence from included studies demonstrated that the endoscopic group was associated with shorter length of hospital stay and lower hospital cost compared to the surgical group.

CONCLUSION

Endoscopic treatment may be the first-line treatment approach for patients with pancreatic pseudocyst.

摘要

背景与目的

评估与手术治疗相比,内镜治疗胰腺假性囊肿的有效性和安全性。

方法

系统检索PubMed和Cochrane图书馆,以识别所有比较内镜与手术治疗胰腺假性囊肿的对照试验。主要结局指标包括治疗成功率、不良事件、复发率、住院时间和住院费用。

结果

本荟萃分析纳入了5项对照研究,共255名参与者。手术组的治疗成功率高于内镜组(OR,0.43;95%CI,0.20 - 0.95;P = 0.04)。然而,内镜组与手术组在不良事件发生率(OR,0.67;95%CI,0.33 - 1.36;P = 0.27)或复发率(OR,1.53;95%CI,0.37 - 6.39;P = 0.56)方面没有差异。纳入研究的证据表明,与手术组相比,内镜组的住院时间更短,住院费用更低。

结论

内镜治疗可能是胰腺假性囊肿患者的一线治疗方法。

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