Hydrogen peroxide–assisted endoscopic necrosectomy of pancreatic walled-off necrosis: a systematic review and meta-analysis - 16/05/22
Abstract |
Background and Aims |
Use of hydrogen peroxide (H2O2) has been reported in direct endoscopic necrosectomy (DEN) of pancreatic walled-off necrosis (WON). The aim of this meta-analysis was to study the pooled clinical outcomes of H2O2-assisted DEN of pancreatic WON.
Methods |
We conducted a comprehensive search of several databases (inception to July 2021) to identify studies reporting on the use of H2O2 in DEN of WON. A random-effects model was used to calculate pooled rates and I2 values, and 95% prediction intervals were used to assess heterogeneity. The outcomes studied were technical success, clinical success, and adverse events in H2O2-assisted DEN of pancreatic WON.
Results |
In 7 analyzed studies, 186 patients underwent H2O2-assisted DEN of WON. The pooled rate of technical success was 95.8% (95% confidence interval [CI], 88.5-98.5), clinical success was 91.6% (95% CI, 86.1-95), and cumulative rate of overall adverse events was 19.3% (95% CI, 7.6-41). The pooled rate of bleeding was 7.9% (95% CI, 2.4-22.7), stent migration was 11.3% (95% CI, 4.9-23.9), perforation 5.4% (95% CI, 1.7-15.7), infection 5.7% (95% CI, 2-15.1), and pulmonary adverse event 2.9% (95% CI, 1.3-6.1). Mean treatment sessions ranged from 2 to 5.
Conclusions |
H2O2-assisted DEN of WON demonstrated excellent clinical outcomes, with minimal heterogeneity. No adverse events attributable to H2O2 were reported. Future controlled studies are warranted comparing the clinical outcomes with and without H2O2 before H2O2 use can be established in DEN of pancreatic WON.
Le texte complet de cet article est disponible en PDF.Abbreviations : CI, DEN, H2O2, WON
Plan
| DISCLOSURE: The following author disclosed financial relationships: D. G. Adler: Consultant for Boston Scientific. All other authors disclosed no financial relationships. |
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| DIVERSITY, EQUITY, AND INCLUSION: One or more of the authors of this article self-identifies as an under-represented gender minority in science. One or more of the authors of this article self-identifies as an under-represented ethnic minority in science. While citing references scientifically relevant for this work, we actively worked to promote gender balance in our reference list. |
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| If you would like to chat with an author of this article, you may contact Dr Adler at Douglasadler@centura.org. |
Vol 95 - N° 6
P. 1060 - juin 2022 Retour au numéro
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