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An endoscopic or minimally invasive surgical approach for infected necrotizing pancreatitis: a systematic review and meta-analysis
Hu, Yong; Li, Chunyan; Zhao, Xin; Cui, Yunfeng.
Afiliação
  • Hu, Yong; Tianjin Medical University. Tianjin. China
  • Li, Chunyan; Tianjin Medical University. Tianjin. China
  • Zhao, Xin; Tianjin Medical University. Tianjin. China
  • Cui, Yunfeng; Tianjin Medical University. Tianjin Nankai Hospital. Department of Surgery. Tianjin. China
Rev. esp. enferm. dig ; 111(6): 471-480, jun. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-190083
Biblioteca responsável: ES1.1
Localização: BNCS
ABSTRACT
Background and

aim:

the incidence of acute pancreatitis is rising across the world, thus further increasing the burden on healthcare services. Approximately 10% of patients with acute pancreatitis will develop infected necrotizing pancreatitis (INP), which is the leading cause of high mortality in the late phase. There is currently no consensus with regard to the use of endoscopic or minimally invasive surgery as the first-line therapy of choice for INP. However, more clinical research with regard to the superiority of an endoscopic approach has been recently published. Therefore, we conducted a systematic review and meta-analysis to determine which of the two treatments leads to a better prognosis.

Methods:

four databases (Medline, SINOMED, EMBASE and Cochrane Library) were searched for eligible studies from 1980 to 2018, comparing endoscopic and minimally invasive surgery for INP.

Results:

two randomized controlled trials (RCTs) and seven clinical cohort studies were included. After the analysis of data amenable to polling, significant advantages were found in favor of the endoscopic approach in terms of pancreatic fistulas (OR = 0.10, 95% CI 0.04-0.30, p < 0.001) and the length of hospital stay (weighted mean difference [WMD] = -24.72, 95% CI = -33.87 to -15.57, p < 0.001). No marked differences were found in terms of mortality, multiple organ failure, intra-abdominal bleeding, enterocutaneous fistula, recurrence of pseudocysts, and length of stay (LOS) in the Intensive Care Unit (ICU), endocrine insufficiency and exocrine insufficiency.

Conclusion:

compared with minimally invasive surgery, an endoscopic approach evidently improved short-term outcomes for infected necrotizing pancreatitis, including pancreatic fistula and the length of hospital stay. Furthermore, relevant multicenter RCTs are eager to validate these

findings:

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Coleções: Bases de dados nacionais / Espanha Base de dados: IBECS Assunto principal: Pâncreas / Endoscopia Gastrointestinal / Pancreatite Necrosante Aguda Limite: Humanos Idioma: Inglês Revista: Rev. esp. enferm. dig Ano de publicação: 2019 Tipo de documento: Artigo Instituição/País de afiliação: Tianjin Medical University/China
Buscar no Google
Coleções: Bases de dados nacionais / Espanha Base de dados: IBECS Assunto principal: Pâncreas / Endoscopia Gastrointestinal / Pancreatite Necrosante Aguda Limite: Humanos Idioma: Inglês Revista: Rev. esp. enferm. dig Ano de publicação: 2019 Tipo de documento: Artigo Instituição/País de afiliação: Tianjin Medical University/China
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