The efficacy of some therapeutic methods (open surgical debridement (OSD), conservative treatment (CST) and minimally invasive drainage (MID)) for severe acute pancreatitis (SAP) and moderately severe acute pancreatitis (MSAP) has been widely evaluated. However, the results remained controversial. We performed this study to illuminate whether any difference in incidence exists on patients with SAP/MSAP treated with OSD and MID. Eligible articles were collected base of a comprehensive review of PUBMED, EMBASE, COCHRANE, CKNI and WANGFANG for published randomized controlled trials. Two steps of meta-analysis were performed, routine pair-wise meta-analysis and network meta-analysis. Thirteen studies were included in this study. Participants were classed as 5 groups, CST, early MID (EMID), late MID (LMID), early OSD (EOSD) and late OSD (LOSD). And MID contains endoscopic drainage (ESD), percutaneous catheter drainage (PCD) and minimally invasive surgery (MIS). Compared with CST, MID could decrease both mortality and multiple organ dysfunction syndrome (MODS) rate but OSD couldn’t. Both EMID and MID can significantly decrease the mortality and MODS rate compared to CST. PCD might be most likely to have a benefit compared to CST. Existing evidence for the use of MID in SAP/MSAP is reliable and it can be used as early treatment. OSD, if necessary, should be avoided or delayed as long as possible.

中文翻译：

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SAP / SMAP中的微创引流术与开放性手术清创术–网络荟萃分析

已经广泛评估了某些治疗方法（开放手术清创术（OSD），保守治疗（CST）和微创引流（MID））对重症急性胰腺炎（SAP）和中度重症急性胰腺炎（MSAP）的疗效。但是，结果仍然存在争议。我们进行了这项研究，以阐明接受OSD和MID治疗的SAP / MSAP患者的发病率是否存在差异。收集符合条件的文章，对PUBMED，EMBASE，Cochrane，CKNI和WANGFANG进行全面综述，以发表随机对照试验。进行了荟萃分析的两个步骤，即常规的成对荟萃分析和网络荟萃分析。这项研究包括十三项研究。参与者分为5组：CST，早期MID（EMID），晚期MID（LMID），早期OSD（EOSD）和晚期OSD（LOSD）。MID包括内窥镜引流（ESD），经皮导管引流（PCD）和微创手术（MIS）。与CST相比，MID可以降低死亡率和多器官功能障碍综合症（MODS）发生率，而OSD则不能。与CST相比，EMID和MID均可显着降低死亡率和MODS率。与CST相比，PCD最有可能受益。在SAP / MSAP中使用MID的现有证据是可靠的，可以用作早期治疗。如有必要，应避免或尽可能长地延迟OSD。与CST相比，EMID和MID均可显着降低死亡率和MODS率。与CST相比，PCD最有可能受益。在SAP / MSAP中使用MID的现有证据是可靠的，可以用作早期治疗。如有必要，应避免或尽可能长地延迟OSD。与CST相比，EMID和MID均可显着降低死亡率和MODS率。与CST相比，PCD最有可能受益。在SAP / MSAP中使用MID的现有证据是可靠的，可以用作早期治疗。如有必要，应避免或尽可能长地延迟OSD。