Success of endoscopic ultrasound-guided ethanol ablation of pancreatic cysts: a meta-analysis and systematic review.

Autor: Kandula M; Division of Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, IL, USA, manasakandula14@gmail.com., Moole H, Cashman M, Volmar FH, Bechtold ML, Puli SR
Jazyk: angličtina
Zdroj: Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology [Indian J Gastroenterol] 2015 May; Vol. 34 (3), pp. 193-9. Date of Electronic Publication: 2015 Jun 25.
DOI: 10.1007/s12664-015-0575-2
Abstrakt: Background: Endoscopic ultrasound (EUS)-guided ethanol ablation has emerged as an efficacious and safe alternative management option for pancreatic cysts. We undertook a meta-analysis and systematic review to assess the overall safety and efficacy of EUS-guided ethanol ablation of pancreatic cysts.
Method Study Selection Criteria: EUS-guided ethanol ablation of pancreatic cysts.
Data Collection Extraction: Articles were searched in Medline, Pubmed, and Ovid journals.
Statistical Method: Fixed and random effects models were used to calculate the pooled proportions.
Results: Initial search identified 1,319 reference articles, in which 120 relevant articles were selected and reviewed. Data was extracted from seven studies (n = 152) of EUS-guided ethanol ablation of pancreatic cysts, which met the inclusion criteria. With EUS-guided ethanol ablation, the pooled proportion of patients with complete cyst resolution was 56.20 % (95 % CI = 48.16 to 64.08) and partial cyst resolution was 23.72 % (95 % CI = 17.24 to 30.89). Postprocedural complications after ablation were significant for abdominal pain in 6.51 % (95 % CI = 3.12 to 11.04) and pancreatitis in 3.90 % (95 % CI = 1.39 to 7.60) of the pooled percentage of patients. Publication bias calculated using Harbord-Egger bias indicator gave a value of -1.09 (95 % CI = 10.21 to 8.03, p = 0.77). The Begg-Mazumdar indicator gave a Kendall's tau b value of 0.05 (p ≥ 0.99).
Conclusions: EUS-guided ethanol ablation may be a safe alternative treatment modality for pancreatic cysts, with acceptable intraprocedural and postprocedural complications. However, due to the limited data available, prospective randomized controlled trials with a long follow up period are required in this area.
Databáze: MEDLINE
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