Laparoscopic Intervention to Pancreatic Pseudocyst Confers Short-Term Benefits: A Meta-Analysis.

Yulin Guo,Shuo Wang,Shun Hu,Fei Li,Feng Cao,Ang Li,Roberto Cirocchi

doi:10.1155/2021/7586338

Yulin Guo, Shuo Wang + Show 5 more

Open Access

https://doi.org/10.1155/2021/7586338

Copy DOI

Abstract

Background Surgical interventions for pancreatic pseudocyst (PP) are traditionally managed by an open surgical approach. With the development of minimally invasive surgical techniques, a laparoscopic surgical approach for PPs has been conducted increasingly with comparable outcomes. The present study was conducted to compare the efficacy and safety of surgical intervention for PPs between the laparoscopic approach and the open approach. Methods Databases including Cochrane Library, PubMed, and EMBASE were searched to identify studies that compared the safety and efficacy of surgical intervention for PPs between the laparoscopic approach and the open approach (until Aug 1st 2020). Results A total of 6 studies were eligible in qualitative synthesis. The laparoscopic approach was associated with less intraoperative blood loss (MD = −69.97; 95% CI: −95.14 to −44.70, P < 0.00001; P=0.86 for heterogeneity) and shorter operating time (MD = −33.12; 95% CI: −62.24 to −4.00, P=0.03; P < 0.00001 for heterogeneity). There was no significant difference found between the two approaches regarding the success rate and the recurrence rate. The postoperative complications and mortality rates were comparable between the two approaches. Conclusions The laparoscopic approach for the surgical intervention of PPs is safe and efficacious with shorter-term benefits.

Highlights

Pancreatic pseudocyst (PP) is a localized collection of intrapancreatic and peripancreatic fluid surrounded by a well-defined wall of fibrous or granulation tissue, which results from acute pancreatitis, trauma, chronic pancreatitis, or pancreatic ductal obstruction [1, 2]
As few prospective studies have been conducted to compare the laparoscopic approach and the open approach interventions until today, these surgical interventions were performed mainly based on the experience of surgeons. e present study was the first systemic review to distinguish the potential differences between the two approaches
The pseudocyst is drained to the stomach, duodenum, or the jejunum wall. e present study confirmed that the success rate of the laparoscopic approach was not inferior to that of the open approach

Summary

Introduction

Pancreatic pseudocyst (PP) is a localized collection of intrapancreatic and peripancreatic fluid surrounded by a well-defined wall of fibrous or granulation tissue, which results from acute pancreatitis, trauma, chronic pancreatitis, or pancreatic ductal obstruction [1, 2]. PP should initially be under conservative treatment because up to 85% could be spontaneously resolved within 4 to 6 weeks by its natural history For those PPs that are symptomatic, larger than 6 cm, and/or last for more than 6 weeks, aggressive intervention should be taken to prevent infection, rupture, haemorrhage, and obstruction of the adjacent stomach, bowels, or bile ducts [3, 4]. Surgical interventions for pancreatic pseudocyst (PP) are traditionally managed by an open surgical approach. E present study was conducted to compare the efficacy and safety of surgical intervention for PPs between the laparoscopic approach and the open approach. Databases including Cochrane Library, PubMed, and EMBASE were searched to identify studies that compared the safety and efficacy of surgical intervention for PPs between the laparoscopic approach and the open approach (until Aug 1st 2020).

Methods

Results

Conclusion