Quality of life after surgical and endoscopic management of severe acute pancreatitis: A systematic review

Table 1 Risk of Bias assessment [risk of bias assessment using the Revised Cochrane risk-of-bias for randomised trials (RoB 2.0)]

Ref.	Random sequence generation	Allocation concealment	Blinding of participants and personnel	Blinding of outcome assessment	Incomplete outcome data	Selective reporting	Other bias
Bang et al[11]	+	+	-	?	+	+	-
van Brunschot et al[28]	+	+	-	+	+	+	-
Hollemans et al[30]	+	-	-	-	+	+	-

Risk of bias assessment: +: Low; ?: Unclear; -: High.

Table 2 Risk of Bias assessment [risk of bias assessment using the Revised Cochrane risk-of-bias for randomised trials (RoB 2.0)]

Ref.	Confounding	Selection bias	Bias in classification of interventions	Bias due to deviation from intended interventions	Incomplete outcome data	Blinding of outcome assessment	Selective reporting	Other bias
Seifert et al[27]	-	-	+	+	+	-	+	-
Smith et al[33]	+	+	?	?	-	-	+	-
Cinquepalmi et al[17]	?	+	+	+	-	-	+	-
Fenton-Lee et al[29]	+	-	?	+	+	-	-	-
Kriwanek et al[32]	?	?	-	?	+	-	+	-
Reszetow et al[31]	+	?	+	+	+	-	+	-
Broome et al[16]	-	?	+	-	-	-	+	-
Tu et al[34]	?	+	?	+	+	-	+	-

Risk of bias assessment: +: Low; ?: Unclear; -: High.

Table 3 Study characteristics

Ref.	Country	Hospital	Study design	Study interval	Treatment	Patient cohort	Relevant patients	Patients in study	Questionnaire	Assessment times
Broome et al[16], 1996	USA	Duke University of Medical Centre	Retrospective with prospective follow-up	1988 to 1994	Surgery (operative debridement of necrosis)	Pancreatic necrosis	40 surgically managed patients with pancreatic necrosis	40	SF-36	Average follow-up 51 mo
Fenton-Lee et al[29], 1993	UK	Greater Glasgow Health Board	Prospective	April 1991 to March 1992	Surgery (required operative intervention); 9/10 also received endoscopic procedures	Pancreatic necrosis	10; 10 operative intervention, 9/10 also endoscopic intervention	10	Rosser disability and distress index	Admission and follow-up
Kriwanek et al[32], 1998	Austria	Rudolfstiftung-Hospital	Prospective	January 1 1988 to June 30 1996	Surgery (open necrosectomy)	Pancreatic necrosis	75; 57 survivors	75 with pancreatic necrosis (72 other sources of intra-abdominal infection)	SF-36	Not stated
Cinquepalmi et al[17], 2006	Italy	Not reported	Prospective	1990 to 2005	Surgery (sequential surgical debridement)	Infected pancreatic necrosis	35; all received sequential surgical debridement	35	SF-36	Not reported
Reszetow et al[31], 2007	Poland	Medical University of Gdańsk	Prospective	January 1993 to December 1999	Surgery (Bradley procedure)	Infected pancreatic necrosis	28; 44 (16.1%) of 274 patients with acute pancreatitis; 35/44 (63.4%) survivors for follow-up; 5 excluded	44	Functional Assessment of Chronic Illness Therapy scale	24-96 mo
Seifert et al[27], 2009	Germany	6 centres	Retrospective with prospective follow-up	1999 to 2005, follow-up 2004 to 2008	Endoscopy vs surgery	Infected pancreatic necrosis	93; 75 endoscopic; 18 failed, 11 surgery	93	Study-specific tool	Up to 24 mo
van Brunschot et al[28], 2017	Netherlands	19 centres	Randomized trial	September 20 2011 to January 29 2015	Endoscopy vs surgery	Confirmed or suspected infected pancreatic or peripancreatic necrosis.	98; 51 endoscopic and 47 surgical	98	EQ-5D-3L	3 and 6 mo
Hollemans et al[30], 2019	Netherlands		Randomized trial	November 2005 to October 2008	Surgery (step-up approach (primary percutaneous catheter drainage, followed by, if necessary, minimally invasive retroperitneal necrosectomy) vs open necrosectomy	Confirmed or suspected infected pancreatic necrosis.	60; 28/43 step-up approach (8 died), 32/45 open necrosectomy (7 died)	88	SF-36 and EuroQol	3, 6, and 12 mo after discharge
Smith et al[33], 2019	USA	Barnes-Jewish Hospital/Washington University School of Medicine	Retrospective with prospective follow-up	January 2006 to May 2016	Endoscopy	Walled off necrosis	41 (returned QoL questionnaires)	98	SF-36	Mean 37.4 (range 1-139) mo
Bang et al[11], 2020	USA	Florida Hospital	Randomized trial	May 12 2014 to March 24 2017	Endoscopy vs surgery	Confirmed or suspected infected pancreatic or peripancreatic necrosis.	66; 34 endoscopic and 32 surgery	66	SF-36	3 and 6 mo
Tu et al[34], 2020	China	Jinling Hospital, Medical School of Nanjing University	Retrospective with prospective follow-up	January 2000 to February 2015	Surgery (open necrosectomy) vs minimally invasive drainage	Infected pancreatic necrosis	109; 101 included in analysis (61 minimally invasive drainage, 40 open necrosectomy)	109	SF-36	Not stated