Efficacy of fully covered self-expandable metal stents and comparison with conventional management for ERCP-related type II perforations: a systematic review and meta-analysis.

BACKGROUND AND AIMS: Conservative management is often used in the management of ERCP-related type II perforations. In this meta-analysis, we have evaluated the efficacy of fully covered self-expandable metal stents (FCSEMSs) in the management of type II perforations and also compared these with conventional management.

METHODS

We reviewed several databases from inception to December 12, 2024. Outcomes of interest were clinical success, need for percutaneous catheter drainage (PCD) or surgery, pancreatitis, length of hospital stay, and mortality. Data were analyzed using a random effects model.

RESULTS

The rate of clinical success was significantly higher (OR, 9.96; 95% CI, 1.83-54.12), rate of surgery and need for PCD significantly lower (OR, 0.09; 95% CI, 0.01-0.63), and length of hospital stay significantly shorter (mean difference, -9.90; 95% CI, -17.61 to -2.20) in the FCSEMS group.

CONCLUSIONS

This meta-analysis demonstrates the superiority of FCSEMSs in achieving better outcomes compared with conventional management of type II perforations.