Evidence map›Paper›PMID 34026217›Full record

ArticleGastroenterology report2021

Endoscopic pancreatic duct stenting for pain palliation in selected pancreatic cancer patients: a systematic review and meta-analysis.

Pradeep K Siddappa, Fadi Hawa, Larry J Prokop, M Hassan Murad, Barham K Abu Dayyeh, Vinay Chandrasekhara, Mark D Topazian, Fateh Bazerbachi

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Gastroenterology report, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 2 pooled it
1.6field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 24 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 1 country.

Pradeep K SiddappaDivision of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA.
Fadi HawaDepartment of Internal Medicine, St. Joseph Mercy Ann Arbor Hospital, Ypsilanti, MI, USA.
Larry J ProkopLibrary Public Services, Mayo Clinic, Rochester, MN, USA.
M Hassan MuradRobert D and Patricia E Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA.
Barham K Abu DayyehDivision of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
Vinay ChandrasekharaDivision of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.ORCID https://orcid.org/0000-0001-6209-9905
Mark D TopazianDivision of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
Fateh BazerbachiDivision of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.ORCID https://orcid.org/0000-0003-4599-2042
Mayo Clinic in Arizona · USHarvard University · USMayo Clinic · USStanford University · USTrinity Health Ann Arbor Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAbdominal pain is a debilitating symptom affecting ∼80% of pancreatic cancer (PC) patients. Pancreatic duct (PD) decompression has been reported to alleviate this pain, although this practice has not been widely adopted. We aimed to evaluate the role, efficacy, and safety of endoscopic PD decompression for palliation of PC post-prandial obstructive-type pain.

methodsA systematic review until 7 October 2020 was performed. Two independent reviewers selected studies, extracted data, and assessed the methodological quality.

resultsWe identified 12 publications with a total of 192 patients with PC presenting with abdominal pain, in whom PD decompression was attempted, and was successful in 167 patients (mean age 62.5 years, 58.7% males). The use of plastic stents was reported in 159 patients (95.2%). All included studies reported partial or complete improvement in pain levels after PD stenting, with an improvement rate of 93% (95% confidence interval, 79%-100%). The mean duration of pain improvement was 94 ± 16 days. Endoscopic retrograde cholangiopancreatography (ERCP)-related adverse events (AEs) were post-sphincterotomy bleeding (1.8%), post-ERCP pancreatitis (0.6%), and hemosuccus pancreaticus (0.6%). AEs were not reported in two patients who underwent endoscopic ultrasound-guided PD decompression. In the 167 patients with technical success, the stent-migration and stent-occlusion rates were 3.6% and 3.0%, respectively. No AE-related mortality was reported. The methodological quality assessment showed the majority of the studies having low or unclear quality.

conclusionIn this exploratory analysis, endoscopic PD drainage may be an effective and safe option in selected patients for the management of obstructive-type PC pain. However, a randomized-controlled trial is needed to delineate the role of this invasive practice.

Indexed as

cancer-associated painEndoscopic retrograde cholangiopancreatographymeta-analysispalliative therapypancreas cancersystematic review

Identifiers

PMID34026217
PMCPMC8128017
OpenAlexW3127829815

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.