Early versus Delayed Minimally Invasive Intervention for Acute Necrotizing Pancreatitis: An Updated Systematic Review and Meta-Analysis
| العنوان: | Early versus Delayed Minimally Invasive Intervention for Acute Necrotizing Pancreatitis: An Updated Systematic Review and Meta-Analysis |
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| المؤلفون: | Leilei Zhu, Jingyi Shen, Rongrong Fu, Xiaozhen Lu, Liwen Du, Ruihao Jiang, Mengting Zhang, Yetan Shi, Ke Jiang, Yongwei Shi |
| المصدر: | Digestive Surgery. 39:224-231 |
| بيانات النشر: | S. Karger AG, 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Gastroenterology, Surgery |
| الوصف: | Background: Nowadays, minimally invasive intervention (MII) has largely replaced delayed open surgery in acute necrotizing pancreatitis (ANP). However, the timing of MII remains unclear. The present study investigated the effect of early versus delayed MII on complications in ANP. Methods: Studies evaluating the impact of the timing of MII on complications in ANP patients were thoroughly searched on PubMed, Embase, Cochrane Library, and Web of Science from inception to June 2022. The primary outcome of interest was mortality. Secondary outcomes were the incidence of complications. Results: Nine studies reporting 870 patients undergoing MII for ANP were included. No significant difference was found in mortality between the early and delayed intervention groups. In addition, the timing of MII was not associated with the incidence of new-onset respiratory failure, new-onset cardiovascular failure, new-onset renal failure, new-onset multiple organ failure, gastrointestinal fistula or perforation, pancreatic fistula, stent migration, bleeding, venous thrombosis, and new-onset pancreatic endocrine insufficiency. Notably, in the subgroup analysis of biliary and Asian ANP patients, early intervention was associated with a significantly higher risk of new-onset renal failure than delayed intervention. Conclusions: Early intervention is safe and recommended only for patients with indications for intervention, such as infection. |
| تدمد: | 1421-9883 0253-4886 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::977bfd5163a20cca5ffe716a4574148c https://doi.org/10.1159/000529465 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi...........977bfd5163a20cca5ffe716a4574148c |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14219883 02534886 |
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