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

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

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.

Related collections

Most cited references 20

Record: found
Abstract: found
Article: found

Is Open Access

Estimating the mean and variance from the median, range, and the size of a sample

Stela Pudar Hozo, Benjamin Djulbegovic, Iztok Hozo (2005)

Background Usually the researchers performing meta-analysis of continuous outcomes from clinical trials need their mean value and the variance (or standard deviation) in order to pool data. However, sometimes the published reports of clinical trials only report the median, range and the size of the trial. Methods In this article we use simple and elementary inequalities and approximations in order to estimate the mean and the variance for such trials. Our estimation is distribution-free, i.e., it makes no assumption on the distribution of the underlying data. Results We found two simple formulas that estimate the mean using the values of the median (m), low and high end of the range (a and b, respectively), and n (the sample size). Using simulations, we show that median can be used to estimate mean when the sample size is larger than 25. For smaller samples our new formula, devised in this paper, should be used. We also estimated the variance of an unknown sample using the median, low and high end of the range, and the sample size. Our estimate is performing as the best estimate in our simulations for very small samples (n ≤ 15). For moderately sized samples (15 70), the formula range/6 gives the best estimator for the standard deviation (variance). We also include an illustrative example of the potential value of our method using reports from the Cochrane review on the role of erythropoietin in anemia due to malignancy. Conclusion Using these formulas, we hope to help meta-analysts use clinical trials in their analysis even when not all of the information is available and/or reported.

0 comments Cited 1873 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus.

Peter A Banks, Thomas L Bollen, Christos Dervenis … (2013)

The Atlanta classification of acute pancreatitis enabled standardised reporting of research and aided communication between clinicians. Deficiencies identified and improved understanding of the disease make a revision necessary. A web-based consultation was undertaken in 2007 to ensure wide participation of pancreatologists. After an initial meeting, the Working Group sent a draft document to 11 national and international pancreatic associations. This working draft was forwarded to all members. Revisions were made in response to comments, and the web-based consultation was repeated three times. The final consensus was reviewed, and only statements based on published evidence were retained. The revised classification of acute pancreatitis identified two phases of the disease: early and late. Severity is classified as mild, moderate or severe. Mild acute pancreatitis, the most common form, has no organ failure, local or systemic complications and usually resolves in the first week. Moderately severe acute pancreatitis is defined by the presence of transient organ failure, local complications or exacerbation of co-morbid disease. Severe acute pancreatitis is defined by persistent organ failure, that is, organ failure >48 h. Local complications are peripancreatic fluid collections, pancreatic and peripancreatic necrosis (sterile or infected), pseudocyst and walled-off necrosis (sterile or infected). We present a standardised template for reporting CT images. This international, web-based consensus provides clear definitions to classify acute pancreatitis using easily identified clinical and radiologic criteria. The wide consultation among pancreatologists to reach this consensus should encourage widespread adoption.

0 comments Cited 1279 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Pancreatic pseudocyst.

Samir Habashi, Peter V Draganov (2009)

Pancreatic pseudocysts are complications of acute or chronic pancreatitis. Initial diagnosis is accomplished most often by cross-sectional imaging. Endoscopic ultrasound with fine needle aspiration has become the preferred test to help distinguish pseudocyst from other cystic lesions of the pancreas. Most pseudocysts resolve spontaneously with supportive care. The size of the pseudocyst and the length of time the cyst has been present are poor predictors for the potential of pseudocyst resolution or complications, but in general, larger cysts are more likely to be symptomatic or cause complications. The main two indications for some type of invasive drainage procedure are persistent patient symptoms or the presence of complications (infection, gastric outlet or biliary obstruction, bleeding). Three different strategies for pancreatic pseudocysts drainage are available: endoscopic (transpapillary or transmural) drainage, percutaneous catheter drainage, or open surgery. To date, no prospective controlled studies have compared directly these approaches. As a result, the management varies based on local expertise, but in general, endoscopic drainage is becoming the preferred approach because it is less invasive than surgery, avoids the need for external drain, and has a high long-term success rate. A tailored therapeutic approach taking into consideration patient preferences and involving multidisciplinary team of therapeutic endoscopist, interventional radiologist and pancreatic surgeon should be considered in all cases.

0 comments Cited 92 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Feng Cao:

ORCID: https://orcid.org/0000-0001-7412-2455

Fei Li:

ORCID: https://orcid.org/0000-0002-0532-9054

Journal

Journal ID (nlm-ta): Emerg Med Int

Journal ID (iso-abbrev): Emerg Med Int

Journal ID (publisher-id): emi

Title: Emergency Medicine International

Publisher: Hindawi

ISSN (Print): 2090-2840

ISSN (Electronic): 2090-2859

Publication date Collection: 2021

Publication date (Electronic): 17 November 2021

Volume: 2021

Electronic Location Identifier: 7586338

Affiliations

¹Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China

²Research and Development Department, Sinovac Biotech Ltd, Beijing 100053, China

Author notes

Academic Editor: Roberto Cirocchi

Author information

Yulin Guo https://orcid.org/0000-0003-3563-8998

Shun Hu https://orcid.org/0000-0002-9643-2355

Shuo Wang https://orcid.org/0000-0002-1766-0246

Ang Li https://orcid.org/0000-0002-2018-9678

Feng Cao https://orcid.org/0000-0001-7412-2455

Fei Li https://orcid.org/0000-0002-0532-9054

Article

DOI: 10.1155/2021/7586338

PMC ID: 8612789

PubMed ID: 34840827

SO-VID: 382c023e-a749-4263-9873-4aa6b115f4f3

License:

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 19 May 2021

Date accepted : 15 October 2021

Funding

Funded by: Capital Medical University

Award ID: 1192070312

Funded by: Beijing Municipal Science &Technology Commission

Award ID: Z171100001017077

Award ID: Z191100006619038

Funded by: Beijing Postdoctoral Funding for Scientific Research

Award ID: ZZ2019-18

Comments

Comment on this article

scite_

Smart Citations

Citing PublicationsSupportingMentioningContrasting

View Citations

See how this article has been cited at scite.ai

scite shows how a scientific paper has been cited by providing the context of the citation, a classification describing whether it supports, mentions, or contrasts the cited claim, and a label indicating in which section the citation was made.