A meta-analysis and systematic review of percutaneous catheter drainage in treating infected pancreatitis necrosis

BACKGROUND: In the current meta-analysis, we focus on the exploration of percutaneous catheter drainage (PCD) in terms of its overall safety as well as efficacy in the treatment of infected pancreatitis necrosis based on qualified studies. METHODS: The following electronic databases were searched to identify eligible studies through the use of index words updated to May 2018: PubMed, Cochrane, and Embase. Relative risk (RR) or mean difference (MD) along with 95% confidence interval (95% CI) were utilized for the main outcomes. RESULTS: A total of 622 patients in the PCD group and 650 patients in the control group from 13 studies were included in the present meta-analysis. The aggregated results indicated that the incidence of bleeding was decreased significantly (RR: 0.42, 95% CI: 0.25–0.70) in the PCD group as compared with the control group. In addition, PCD decreased the mortality (RR: 0.76, 95% CI: 0.41–1.42), hospital duration (SMD: −0.22, 95% CI: −0.77 to –0.33), duration in intensive care unit (ICU) (SMD: −0.13, 95% CI: −0.30 to –0.04), pancreatic fistula (RR: 0.73, 95% CI: 0.46–1.17), and organ failure (RR: 0.91, 95% CI: 0.45–1.82) in comparison with the control group, but without statistical significance. CONCLUSION: Our findings provide evidence for the treatment effect of PCD in the decrease of bleeding, mortality, duration in hospital and ICU, pancreatic fistula, organ failure as compared with the surgical treatment. In conclusion, further studies based on high-quality RCTs with larger sample size and long-term follow-ups are warranted for the confirmation of PCD efficacy in treating infected pancreatitis necrosis.