Background and AimRecently, there has been burgeoning interest in the utilization of fully covered self‐expandable metal stents (FCSEMSs) for managing main pancreatic duct strictures (MPDS) in chronic pancreatitis (CP). The primary aim was to investigate stricture resolution and recurrence rates of FCSEMS placement in patients with symptomatic CP complicated with MPDS.MethodsMEDLINE, EMBASE, and ISI Web of Science and Cochrane Library (up to December 2019) were searched to identify eligible studies. A meta‐analysis of stricture resolution and recurrence rates was carried out using R. The crude rate of adverse events related to stent therapy was also calculated.ResultsTen studies involving 163 patients were included. The weighted pooled rate of MPDS resolution was 93% (95% confidence interval [95%CI] 84–99%) with substantial heterogeneity (I2 = 63%). Duration of stent placement more than 3 months did not result in a significantly higher resolution rate than that of 3 months or less (93% vs 93%, P = 0.91). The weighted pooled rate of stricture recurrence was 5% (95%CI: 0–12%). The stricture recurrence rate for patients with duration of stent placement more than 3 months (3%; 95%CI: 0–10%) was lower than that in patients with 3 months or less of stent placement (7%; 95%CI: 0–23%), but not significantly (P = 0.45). The overall rate of adverse events related to stent therapy was 34.9%, and spontaneous stent migration occurred in 14.1% of patients.ConclusionsThe use of FCSEMSs appears to be effective and safe in the management of MPDS caused by symptomatic CP.
Background: The safety of endoscopic retrograde cholangiopancreatography (ERCP) for asymptomatic common bile duct (CBD) stones patients has not been fully studied. This study aimed to compare the incidence and severity of ERCP complications in patients with asymptomatic and symptomatic CBD stones and to provide evidence for the treatment of asymptomatic CBD stones.Methods: The clinical data of patients were retrospectively analyzed. These patients were divided into the asymptomatic CBD stones group and the symptomatic CBD stones group. Propensity score matching (PSM) was used to match the two groups. The incidence and severity of postoperative complications of ERCP in the two groups were analyzed.Results: A total of 79 patients who had asymptomatic CBD stones and 795 patients who had symptomatic CBD stones were included in this study. After PSM, 79 patients from asymptomatic CBD group and 316 patients from the symptomatic CBD stones group were identified. Before and after PSM, there were no significant differences in the incidence and severity of post-ERCP pancreatitis (PEP) between the two groups (P> 0.05). Besides, the incidence and severity of other complications including acute cholangitis, bleeding and perforation in the two groups was no differences before and after PSM (P>0.05).Conclusions: Patients with asymptomatic CBD stones are not at higher risk of getting ERCP-related complications when compared with those with symptomatic ones. ERCP is as safe and effective for asymptomatic CBD stones as for symptomatic patients.
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