Evidence map›Paper›PMID 39030415›Full record

SynthesisSurgical endoscopy2024

Prophylactic pancreatic duct stenting to reduce the risk of post-ampullectomy pancreatitis: a comprehensive review and meta-analysis of 1858 patients.

Saurabh Chandan, Andrew Canakis, Smit Deliwala, Michael Frohlinger, Shahab R Khan, Babu P Mohan, Dushyant S Dahiya, Daryl Ramai, Antonio Facciorusso, Neil R Sharma and 2 more

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Surgical endoscopy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Observational
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

12 authors.

Saurabh Chandan *Center for Interventional Endoscopy (CIE), Advent Health, 601 E Rollins St, Orlando, FL, 32803-1248, USA. saurabhchandan@gmail.com.ORCID 0000-0002-2661-6693
Andrew Canakis *Division of Gastroenterology & Hepatology, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Smit DeliwalaDivision of Digestive Diseases, Emory University, Atlanta, GA, USA.
Michael FrohlingerDepartment of Medicine, George Washington University School of Medicine, Washington, DC, USA.
Shahab R KhanDepartment of Medicine, Brigham and Women Hospital, Boston, MA, USA.
Babu P MohanOrlando Gastroenterology P.A., Orlando, FL, USA.
Dushyant S DahiyaDivision of Gastroenterology Hepatology & Motility, The University of Kansas School of Medicine, Kansas City, Kansas, USA.
Daryl RamaiDivision of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, MA, USA.
Antonio FacciorussoGastroenterology Unit, Department of Surgical and Medical Sciences, University of Foggia, Foggia, Italy.
Neil R SharmaInterventional Oncology & Surgical Endoscopy (IOSE), Peak Gastroenterology Associates, PC, Colorado Springs, CO, USA.
Douglas G AdlerCenter for Advanced Therapeutic Endoscopy (CATE), Centura Health, Porter Adventist Hospital, Denver, CO, USA.
Gursimran S KochharDivision of Gastroenterology, Hepatology & Nutrition, Allegheny Health Network, Pittsburgh, PA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe effectiveness of prophylactic pancreatic duct stenting (PPDS) in preventing post-ampullectomy pancreatitis (PAP) at the time of endoscopic ampullectomy (EA) has been reported, however, results are conflicting. We conducted a systematic review and meta-analysis looking at the use of PPDS in reducing PAP as well as overall post-ampullectomy complications.

methodsMultiple databases were searched through May 2023 for studies reporting on EA. Meta-analysis was performed to determine pooled proportions and relative risk (RR) with 95% confidence intervals (CI) of PAP, with and without PPDS. Pooled rates of adverse events including perforation, delayed bleeding, cholangitis, and procedure related mortality were assessed. Random effects model was used for our meta-analysis and heterogeneity was assessed using the I

resultsThirty-four studies (14 case series, 18 cohort studies and 2 randomized controlled trials) with 1868 patients were included. The overall pooled rate of PAP was 12.3% (CI 10.3-14.5). We found no statistically significant difference in rates of PAP among patients with PPDS, 11.9% (CI 8.9-15.7) and without PPDS, 16.6% (CI 13.4-20.4), RR 0.8 (CI 0.51-1.28), p = 0.4. In terms of severe PAP, we found no difference between the two groups. The overall pooled rates of successful en-bloc and piecemeal resection were 74.8% (CI 67.3-81.1) and 25.1% (CI 19-32.4). Additionally, pooled rates of ampullary stenosis, post procedural bleeding, perforation, cholangitis, and procedure related mortality were 3.6%, 11.1%, 4.2%, 3.5%, and 1.3%, respectively.

conclusionsOur analysis shows that PPDS at the time of EA does not offer a significant protective effect against PAP. While the incidence of PAP was higher among the no PPDS group, it is plausible that this is more likely due to variation among studies in terms of lesion size, length/size of pancreatic stent used and etiology of ampullary lesions. Future well-designed randomized controlled trials are needed to validate our findings.

Indexed as

Ampulla of VaterPancreatic DuctsPancreatitisPostoperative ComplicationsStentsHumansAmpullectomyPancreatic duct stentingPost-ampullectomy pancreatitis

Identifiers

PMID39030415

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.