Endoscopic transmural drainage is associated with improved outcomes in disconnected pancreatic duct syndrome: a systematic review and meta-analysis

Abstract Background Disconnected pancreatic duct syndrome (DPDS) is a complication of acute necrotizing pancreatitis in the neck and body pancreas often manifesting as persistent fluid collection (PFC) or external fistula (EPF). This systematic review pairwise meta-analysis aimed to definitions, clinical presentation, intervention, outcomes for DPDS. Methods The PubMed, EMBASE, MEDLINE, SCOPUS databases were systematically searched until February 2020 using PRISMA framework. A was performed assess success rates endoscopic surgical interventions treatment Success DPDS defined long-term resolution symptoms without recurrence PFC, EPF, ascites. Results Thirty studies included quantitative analysis comprising 1355 patients. Acute most common etiology (95.3%, 936/982), followed by chronic (3.1%, 30/982). commonly presented with PFC (83.2%, 948/1140) EPF (13.4%, 153/1140). There significant heterogeneity definition literature. Weighted rate transmural drainage (90.6%, 95%-CI 81.0–95.6%) significantly higher than transpapillary (58.5%, 36.7–77.4). Pairwise showed comparable between which 82% (weighted 68.6–90.5) 87.4% (95%-CI 81.2–91.8), respectively ( P = 0.389). Conclusions Endoscopic superior management had rates. variability definitions strategies warrant standardisation further research.