经皮胰腺相关病变的导管引流：系统评价和荟萃分析。

Percutaneous catheter drainage of pancreatic associated pathologies: A systematic review and meta-analysis.

机构信息

School of Science and Technology, The University of Georgia, Tbilisi, Georgia; Department of Diagnostic & Interventional Radiology of New Hospitals LTD, Tbilisi, Georgia.

Department of Diagnostic & Interventional Radiology of New Hospitals LTD, Tbilisi, Georgia; Department of Radiology, Tbilisi State Medical University (TSMU), Tbilisi, Georgia.

出版信息

Eur J Radiol. 2021 Nov;144:109978. doi: 10.1016/j.ejrad.2021.109978. Epub 2021 Sep 28.

DOI:10.1016/j.ejrad.2021.109978

PMID:34607289

Abstract

PURPOSE

The main goal of this systematic review was to assess the technical and clinical success, adverse events (AEs), surgery, and overall mortality proportion after percutaneous catheter drainage (PCD) of two pancreatic lesions.

METHODS

An extant search in online databases including Scopus, PubMed (Medline), Embase (Elsevier), Web of Science, Cochrane library, and Google Scholar, was conducted to recognize all studies that used PCD intervention in the management of pancreatic necrosis (PN) and pancreatic pseudocysts (PP). Random effects meta-analysis was performed, and Cochrane's Q test and Istatistic were utilized to determine heterogeneity. In addition, meta-regression was used to explore the influence of categorical variables on heterogeneity.

RESULTS

Thirty-two studies (1398 patients) including PN in 26 (1256 cases, 89.8%) studies and PP in 6 (142 cases, 10.2%) studies were identified. Technical success proportion was 100% (95% confidence interval [CI] 100%-100%, I: 0.0%), clinical success 63% (95% CI 55%-71%, I: 92.9%), AEs 26% (95% CI 21%-31%, I: 78%), surgery after PCD intervention 33% (95% CI 25%-40%, I: 92.4%), and overall mortality was 13% (95% CI 9%-17%, I: 82.8%). The most common ADs after PCD intervention were development of fistula (106, 42.6%), hemorrhage (44, 17.7%), sepsis (40, 16.1%).

CONCLUSION

A significant clinical success proportion with low AEs, surgery, and overall mortality proportion after PCD intervention was found, although the results should be interpreted with caution due to the high heterogeneity.

摘要

目的

本系统评价的主要目的是评估经皮导管引流（PCD）治疗两种胰腺病变的技术和临床成功率、不良事件（AE）、手术和总体死亡率。

方法

在 Scopus、PubMed（Medline）、Embase（Elsevier）、Web of Science、Cochrane 图书馆和 Google Scholar 等在线数据库中进行了现有搜索，以识别所有使用 PCD 干预治疗胰腺坏死（PN）和胰腺假性囊肿（PP）的研究。进行了随机效应荟萃分析，并使用 Cochrane's Q 检验和 I ² 统计量来确定异质性。此外，还进行了 meta 回归以探讨分类变量对异质性的影响。

结果

共纳入 32 项研究（1398 例患者），其中 26 项研究（1256 例，89.8%）为 PN，6 项研究（142 例，10.2%）为 PP。技术成功率为 100%（95%置信区间 [CI] 100%-100%，I：0.0%），临床成功率为 63%（95% CI 55%-71%，I：92.9%），AE 发生率为 26%（95% CI 21%-31%，I：78%），PCD 干预后手术率为 33%（95% CI 25%-40%，I：92.4%），总体死亡率为 13%（95% CI 9%-17%，I：82.8%）。PCD 干预后最常见的 AD 是瘘管形成（106 例，42.6%）、出血（44 例，17.7%）和脓毒症（40 例，16.1%）。