Zaheer Nabi, Rupjyoti Talukdar, Sundeep Lakhtakia, D Nageshwar Reddy
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The secondary outcomes included technical success, adverse events, and recurrence rates.</p><p><strong>Results: </strong>Fourteen studies (187 children, 70.3% male) were included in this review. The subtypes of fluid collection included pseudocysts (60.3%) and walled-off necrosis (39.7%). The pooled technical success rates in studies where drainage of PFCs were performed with and without EUS guidance were 95.3% (95% confidence interval [CI], 89.6-98%; <i>I</i> <sup>2</sup>=0) and 93.9% (95% CI, 82.6-98%; <i>I</i> <sup>2</sup>=0), respectively. The pooled clinical success after one and two endoscopic interventions were 88.7% (95% CI, 82.7-92.9%; <i>I</i> <sup>2</sup>=0) and 92.3% (95% CI, 87.4-95.4%; <i>I</i> <sup>2</sup>=0), respectively. The pooled rate of major adverse events was 6.3% (95% CI, 3.3-11.4%; <i>I</i> <sup>2</sup>=0). The pooled rate of recurrent PFCs after endoscopic drainage was 10.4% (95% CI, 6.1-17.1%; <i>I</i> <sup>2</sup>=0).</p><p><strong>Conclusion: </strong>Endoscopic drainage is safe and effective in children with PFCs. However, future studies are required to compare endoscopic and EUS-guided drainage of PFCs in children.</p>","PeriodicalId":19989,"journal":{"name":"Pediatric Gastroenterology, Hepatology & Nutrition","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9110851/pdf/","citationCount":"0","resultStr":"{\"title\":\"Outcomes of Endoscopic Drainage in Children with Pancreatic Fluid Collections: A Systematic Review and Meta-Analysis.\",\"authors\":\"Zaheer Nabi, Rupjyoti Talukdar, Sundeep Lakhtakia, D Nageshwar Reddy\",\"doi\":\"10.5223/pghn.2022.25.3.251\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Endoscopic drainage is an established treatment modality for adult patients with pancreatic fluid collections (PFCs). Available data regarding the efficacy and safety of endoscopic drainage in pediatric patients are limited. In this systematic review and meta-analysis, we aimed to analyze the outcomes of endoscopic drainage in children with PFCs.</p><p><strong>Methods: </strong>A literature search was performed in Embase, PubMed, and Google Scholar for studies on the outcomes of endoscopic drainage with or without endoscopic ultrasonography (EUS) guidance in pediatric patients with PFCs from inception to May 2021. The study's primary objective was clinical success, defined as resolution of PFCs. The secondary outcomes included technical success, adverse events, and recurrence rates.</p><p><strong>Results: </strong>Fourteen studies (187 children, 70.3% male) were included in this review. The subtypes of fluid collection included pseudocysts (60.3%) and walled-off necrosis (39.7%). The pooled technical success rates in studies where drainage of PFCs were performed with and without EUS guidance were 95.3% (95% confidence interval [CI], 89.6-98%; <i>I</i> <sup>2</sup>=0) and 93.9% (95% CI, 82.6-98%; <i>I</i> <sup>2</sup>=0), respectively. The pooled clinical success after one and two endoscopic interventions were 88.7% (95% CI, 82.7-92.9%; <i>I</i> <sup>2</sup>=0) and 92.3% (95% CI, 87.4-95.4%; <i>I</i> <sup>2</sup>=0), respectively. The pooled rate of major adverse events was 6.3% (95% CI, 3.3-11.4%; <i>I</i> <sup>2</sup>=0). The pooled rate of recurrent PFCs after endoscopic drainage was 10.4% (95% CI, 6.1-17.1%; <i>I</i> <sup>2</sup>=0).</p><p><strong>Conclusion: </strong>Endoscopic drainage is safe and effective in children with PFCs. 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引用次数: 0
摘要
目的：内窥镜引流术是治疗胰腺积液（PFC）成人患者的一种成熟治疗方式。有关内镜引流术在儿童患者中的有效性和安全性的现有数据非常有限。在这篇系统综述和荟萃分析中，我们旨在分析内镜引流术在儿童胰腺积液患者中的疗效：方法：我们在 Embase、PubMed 和 Google Scholar 上检索了从开始到 2021 年 5 月期间有关在内镜超声波（EUS）引导下或不在内镜超声波（EUS）引导下对 PFCs 儿童患者进行内镜引流的结果的文献。研究的首要目标是临床成功，即 PFCs 的消退。次要结果包括技术成功率、不良事件和复发率：本次研究共纳入 14 项研究（187 名儿童，70.3% 为男性）。积液的亚型包括假性囊肿（60.3%）和贴壁坏死（39.7%）。在 EUS 引导和无 EUS 引导的情况下进行 PFCs 引流的研究中，汇总的技术成功率分别为 95.3%（95% 置信区间 [CI]，89.6-98%；I 2=0）和 93.9%（95% 置信区间，82.6-98%；I 2=0）。经过一次和两次内镜干预后，汇总的临床成功率分别为88.7%（95% CI，82.7-92.9%；I 2=0）和92.3%（95% CI，87.4-95.4%；I 2=0）。主要不良事件的汇总发生率为 6.3% (95% CI, 3.3-11.4%; I 2=0)。内镜引流术后PFCs复发的汇总率为10.4% (95% CI, 6.1-17.1%; I 2=0)：结论：内镜下引流术对PFCs患儿安全有效。结论：内镜引流对儿童 PFCs 患者安全有效，但还需在今后的研究中对内镜和 EUS 引导下的儿童 PFCs 引流进行比较。
Outcomes of Endoscopic Drainage in Children with Pancreatic Fluid Collections: A Systematic Review and Meta-Analysis.
Purpose: Endoscopic drainage is an established treatment modality for adult patients with pancreatic fluid collections (PFCs). Available data regarding the efficacy and safety of endoscopic drainage in pediatric patients are limited. In this systematic review and meta-analysis, we aimed to analyze the outcomes of endoscopic drainage in children with PFCs.
Methods: A literature search was performed in Embase, PubMed, and Google Scholar for studies on the outcomes of endoscopic drainage with or without endoscopic ultrasonography (EUS) guidance in pediatric patients with PFCs from inception to May 2021. The study's primary objective was clinical success, defined as resolution of PFCs. The secondary outcomes included technical success, adverse events, and recurrence rates.
Results: Fourteen studies (187 children, 70.3% male) were included in this review. The subtypes of fluid collection included pseudocysts (60.3%) and walled-off necrosis (39.7%). The pooled technical success rates in studies where drainage of PFCs were performed with and without EUS guidance were 95.3% (95% confidence interval [CI], 89.6-98%; I2=0) and 93.9% (95% CI, 82.6-98%; I2=0), respectively. The pooled clinical success after one and two endoscopic interventions were 88.7% (95% CI, 82.7-92.9%; I2=0) and 92.3% (95% CI, 87.4-95.4%; I2=0), respectively. The pooled rate of major adverse events was 6.3% (95% CI, 3.3-11.4%; I2=0). The pooled rate of recurrent PFCs after endoscopic drainage was 10.4% (95% CI, 6.1-17.1%; I2=0).
Conclusion: Endoscopic drainage is safe and effective in children with PFCs. However, future studies are required to compare endoscopic and EUS-guided drainage of PFCs in children.
期刊介绍：
Pediatric Gastroenterology, Hepatology and Nutrition (Pediatr Gastroenterol Hepatol Nutr), an official journal of The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition, is issued bimonthly and published in English. The aim of Pediatr Gastroenterol Hepatol Nutr is to advance scientific knowledge and promote child healthcare by publishing high-quality empirical and theoretical studies and providing a recently updated knowledge to those practitioners and scholars in the field of pediatric gastroenterology, hepatology and nutrition. Pediatr Gastroenterol Hepatol Nutr publishes review articles, original articles, and case reports. All of the submitted papers are peer-reviewed. The journal covers basic and clinical researches on molecular and cellular biology, pathophysiology, epidemiology, diagnosis, and treatment of all aspects of pediatric gastrointestinal diseases and nutritional health problems.
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