Abstract
Abstract
Background
Pancreatic pseudocyst (PP), following acute or chronic pancreatitis, may become symptomatic or persist beyond 6–8 weeks, requiring drainage. Endoscopic ultrasonography‐guided drainage (EUS‐D) is the preferred method, using double pigtail plastic stents (DPPS) or self‐expandable metallic stents (SEMS), such as lumen‐apposing metal stents (LAMS). This meta‐analysis compares DPPS and LAMS in EUS‐D for PP, focusing on technical success, clinical success, adverse events (AEs), recurrence, and procedure time.
Methods
A search strategy was conducted in MEDLINE, Embase, Lilacs, and Cochrane databases according to PRISMA guidelines. Random‐effect models were used for statistical analysis based on intention‐to‐treat. Heterogeneity was assessed using the I
2
test. The risk of bias was assessed using the Risk of Bias in Non‐randomized Studies—of Exposures tool. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation Tool.
Results
Ten studies were included: one prospective cohort and nine retrospective cohorts, conducted between 2014 and 2024. A total of 502 patients with PP were treated with EUS‐D. The clinical success rate was higher using LAMS (Risk ratio [RR] = 1.05; 95% confidence interval [CI]: 1.01; 1.09; I
2
= 0%), with shorter procedure time (Mean difference = ‐16.30; 95% CI: ‐27.65; ‐4.94; I
2
= 86%) compared to DPPS. No statistical difference was observed for early and late AEs, recurrence, or technical success.
Conclusion
The study demonstrated that LAMS has a higher clinical success rate and a shorter procedure time compared to DPPS. There is no difference in terms of early and late AEs, recurrence, and technical success.