Comparison Between Lumen-Apposing Metal Stents and Plastic Stents in Endoscopic Ultrasound–Guided Drainage of Pancreatic Fluid Collection

Objectives This study aimed to explore efficacy and safety between LAMSs (lumen-apposing metal stents) and DPPSs (double-pigtail plastic stents) in endoscopic ultrasound–guided drainage for pancreatic fluid collections. Methods Electronic databases were searched to identify relevant studies published until July 20, 2020. Results Fifteen studies were identified in this study. Endoscopic ultrasound–guided drainage with LAMS has higher clinical success (90.01% vs 82.56%) (odds ratio [OR], 2.44; 95% confidence interval [CI], 1.79–3.33; P < 0.00001), less recurrence (OR, 0.44; 95% CI, 0.29–0.68; P = 0.0002), and fewer additional interventions (OR, 0.34; 95% CI, 0.211–0.55; P < 0.001). There was no significant difference between LAMS and DPPS in technical success (97.45% vs 97.38%) (OR, 0.92; 95% CI, 0.50–1.70; P = 0.80), adverse events (OR, 0.92; 95% CI, 0.41–2.09; P = 0.84), stent-related adverse events (OR, 0.78; 95% CI, 0.39–1.54; P = 0.47), and bleeding (OR, 1.47; 95% CI, 0.57–3.28; P = 0.42). Lumen-apposing metal stents have slightly more perforations (OR, 7.10; 95% CI, 1.22–41.30; P = 0.03) in studies of walled-off necrosis. Conclusions Lumen-apposing metal stents have the advantage of higher clinical success, less recurrence, and fewer additional interventions. However, LAMS may increase perforation for walled-off necrosis.