Endoscopic ultrasound-guided versus percutaneous drainage for the management of post-operative fluid collections after distal pancreatectomy
© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature..
BACKGROUND: Post-operative pancreatic fluid collections (POPFCs) can be drained using percutaneous or endoscopic approaches. The primary aim of this study was to compare rates of clinical success between endoscopic ultrasound-guided drainage (EUSD) with percutaneous drainage (PTD) in the management of symptomatic POPFCs after distal pancreatectomy. Secondary outcomes included technical success, total number of interventions, time to resolution, rates of adverse events (AEs), and POPFC recurrence.
METHODS: Adults who underwent distal pancreatectomy from January 2012 to August 2021 and developed symptomatic POPFC in the resection bed were retrospectively identified from a single academic center database. Demographic data, procedural data, and clinical outcomes were abstracted. Clinical success was defined as symptomatic improvement and radiographic resolution without requiring an alternate drainage modality. Quantitative variables were compared using a two-tailed t-test and categorical data were compared using Chi-squared or Fisher's exact tests.
RESULTS: Of 1046 patients that underwent distal pancreatectomy, 217 met study inclusion criteria (median age 60 years, 51.2% female), of whom 106 underwent EUSD and 111 PTD. There were no significant differences in baseline pathology and POPFC size. PTD was generally performed earlier after surgery (10 vs. 27 days; p < 0.001) and more commonly in the inpatient setting (82.9% vs. 49.1%; p < 0.001). EUSD was associated with a significantly higher rate of clinical success (92.5% vs. 76.6%; p = 0.001), fewer median number of interventions (2 vs. 4; p < 0.001), and lower rate of POPFC recurrence (7.6% vs. 20.7%; p = 0.007). AEs were similar between EUSD (10.4%) and PTD (6.3%, p = 0.28), with approximately one-third of EUSD AEs due to stent migration.
CONCLUSION: In patients with POPFCs after distal pancreatectomy, delayed drainage with EUSD was associated with higher rates of clinical success, fewer interventions, and lower rates of recurrence than earlier drainage with PTD.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:37 |
|---|---|
| Enthalten in: |
Surgical endoscopy - 37(2023), 9 vom: 15. Sept., Seite 6922-6929 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Fogwe, Delvise T [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
EUS-guided drainage |
|---|
| Anmerkungen: |
Date Completed 31.08.2023 Date Revised 10.09.2023 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1007/s00464-023-10188-6 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM358239486 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM358239486 | ||
| 003 | DE-627 | ||
| 005 | 20231226074324.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s00464-023-10188-6 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1194.xml |
| 035 | |a (DE-627)NLM358239486 | ||
| 035 | |a (NLM)37322361 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Fogwe, Delvise T |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Endoscopic ultrasound-guided versus percutaneous drainage for the management of post-operative fluid collections after distal pancreatectomy |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 31.08.2023 | ||
| 500 | |a Date Revised 10.09.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. | ||
| 520 | |a BACKGROUND: Post-operative pancreatic fluid collections (POPFCs) can be drained using percutaneous or endoscopic approaches. The primary aim of this study was to compare rates of clinical success between endoscopic ultrasound-guided drainage (EUSD) with percutaneous drainage (PTD) in the management of symptomatic POPFCs after distal pancreatectomy. Secondary outcomes included technical success, total number of interventions, time to resolution, rates of adverse events (AEs), and POPFC recurrence | ||
| 520 | |a METHODS: Adults who underwent distal pancreatectomy from January 2012 to August 2021 and developed symptomatic POPFC in the resection bed were retrospectively identified from a single academic center database. Demographic data, procedural data, and clinical outcomes were abstracted. Clinical success was defined as symptomatic improvement and radiographic resolution without requiring an alternate drainage modality. Quantitative variables were compared using a two-tailed t-test and categorical data were compared using Chi-squared or Fisher's exact tests | ||
| 520 | |a RESULTS: Of 1046 patients that underwent distal pancreatectomy, 217 met study inclusion criteria (median age 60 years, 51.2% female), of whom 106 underwent EUSD and 111 PTD. There were no significant differences in baseline pathology and POPFC size. PTD was generally performed earlier after surgery (10 vs. 27 days; p < 0.001) and more commonly in the inpatient setting (82.9% vs. 49.1%; p < 0.001). EUSD was associated with a significantly higher rate of clinical success (92.5% vs. 76.6%; p = 0.001), fewer median number of interventions (2 vs. 4; p < 0.001), and lower rate of POPFC recurrence (7.6% vs. 20.7%; p = 0.007). AEs were similar between EUSD (10.4%) and PTD (6.3%, p = 0.28), with approximately one-third of EUSD AEs due to stent migration | ||
| 520 | |a CONCLUSION: In patients with POPFCs after distal pancreatectomy, delayed drainage with EUSD was associated with higher rates of clinical success, fewer interventions, and lower rates of recurrence than earlier drainage with PTD | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a EUS-guided drainage | |
| 650 | 4 | |a Pancreatectomy | |
| 650 | 4 | |a Percutaneous | |
| 650 | 4 | |a Post-operative fluid collection | |
| 700 | 1 | |a AbiMansour, Jad P |e verfasserin |4 aut | |
| 700 | 1 | |a Truty, Mark J |e verfasserin |4 aut | |
| 700 | 1 | |a Levy, Michael J |e verfasserin |4 aut | |
| 700 | 1 | |a Storm, Andrew C |e verfasserin |4 aut | |
| 700 | 1 | |a Law, Ryan J |e verfasserin |4 aut | |
| 700 | 1 | |a Vargas, Eric J |e verfasserin |4 aut | |
| 700 | 1 | |a Fleming, Chad J |e verfasserin |4 aut | |
| 700 | 1 | |a Andrews, James C |e verfasserin |4 aut | |
| 700 | 1 | |a Cleary, Sean P |e verfasserin |4 aut | |
| 700 | 1 | |a Kendrick, Michael L |e verfasserin |4 aut | |
| 700 | 1 | |a Martin, John A |e verfasserin |4 aut | |
| 700 | 1 | |a Bofill-Garcia, Aliana M |e verfasserin |4 aut | |
| 700 | 1 | |a Dayyeh, Barham K Abu |e verfasserin |4 aut | |
| 700 | 1 | |a Chandrasekhara, Vinay |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Surgical endoscopy |d 1996 |g 37(2023), 9 vom: 15. Sept., Seite 6922-6929 |w (DE-627)NLM012660159 |x 1432-2218 |7 nnns |
| 773 | 1 | 8 | |g volume:37 |g year:2023 |g number:9 |g day:15 |g month:09 |g pages:6922-6929 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s00464-023-10188-6 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 37 |j 2023 |e 9 |b 15 |c 09 |h 6922-6929 | ||