Minimally Invasive Drainage Versus Open Surgical Debridement for Severe Acute Pancreatitis: a Meta-Analysis and Systemic Review
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Zhe Song, Zhenyu Yang, Ming Hou
Objective This study compared the treatment outcomes between minimally invasive drainage (MID) and open surgical debridement (OSD) for severe acute pancreatitis (SAP). Methods Reviewers manually searched PubMed/MEDLINE, China National Knowledge Infrastructure database, WANFANG database, and China Biology Medicine database for studies reporting on the use of MID and OSD for treating SAP. All publications from inception to January 2021 were considered. Randomized control trials (RCTs) with SAP diagnoses made based on the 2019 WSES guidelines for the management of SAP, wherein the included SAP patients underwent MID or OSD treatment were included in this study. A PRISMA recommended tool was used for assessing the risk of bias of the included RCTs. Results In all, 1050 publications were identified. However, after applying the inclusion and exclusion criteria, 12 RCTs including 1167 patients who received OSDs (n = 501) and MIDs (n = 666) were considered eligible. The META-analysis indicated that compared with OSD, MID showed a decrease in the mortality (fixed-effects model: OR = 0.41, 95% CI: 0.31–0.54) and morbidity rate with regard to multiple organ dysfunction syndrome, MODS (fixed-effects model: OR=0.25, 95% CI: 0.14–0.45). Conclusions Compared with OSD, MID is an effective measure to treat SAP. MID can significantly decrease the mortality rate and the incidence of MODS and improve patient outcomes in SAP.
Minimally invasive drainage, Open surgical debridement, Severe acute pancreatitis, Outcome, Meta-analysis