Effectiveness of early endoscopic ultrasound-guided drainage for postoperative fluid collection

Oh, Dongwook; Lee, Hwaryong; Song, Tae Jun; Park, Do Hyun; Lee, Sung Koo; Kim, Myung–Hwan; Song, Ki Byung; Lee, Jae Hoon; Hwang, Dae Wook; Kim, Song Cheol; Lee, Seung Soo; Lee, Sang Soo

doi:10.1007/s00464-020-08247-3

Cited by 6 publications

(10 citation statements)

References 26 publications

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“…The placement of drainage tubes itself only serves an observation purpose and cannot replace repeat surgery for haemostasis 32 . In addition, when complications such as bile leakage and intra‐abdominal fluid accumulation occur, drainage can still be performed under the guidance of ultrasound or computed tomography 33 . Therefore, reducing the placement of drainage tubes has certain positive implications in hepato‐biliary resection surgeries.…”

Section: Discussionmentioning

confidence: 99%

The effect of placing prophylactic abdominal drainage tube after hepatobiliary surgery on postoperative infection: A systematic review and meta‐analysis

Liang,

Liu,

Liu

et al. 2024

International Wound Journal

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Whether prophylactic abdominal drainage tube is routinely placed in patients after hepatobiliary surgery remains controversial. To evaluate the effect of prophylactic abdominal drainage tube placement after hepatobiliary surgery on postoperative infection. Randomized controlled trials on the placement of prophylactic abdominal drainage tube after hepatobiliary surgery were collected through a computerized search of PubMed, Embase, Conchrane Library and Web of Science databases, with a time range from the establishment of the database to August 2023. After two researchers independently screened the literature, extracted information, and evaluated the quality of the included studies. Finally, 13 studies were included, including 3620 patients, and the results showed that there was no statistically significant difference in postoperative infection rate between the drainage group (1840 patients and the non‐drainage group [1783 patients] [relative risk, RR = 1.17, 95% confidence interval, CI: 0.94–1.47, p = 0.16]. Compared with the drainage group, the incidence of infectious abdominal fluid in the non‐drainage group was lower (RR = 2.09, 95% CI: 1.57–2.80, p < 0.00001), and the incidence of postoperative bile leakage was lower (RR = 1.77, 95% CI: 1.27–2.47, p < 0.001) and shorter hospital stays after surgery (mean difference = 1.27, 95% CI: 0.32–2.22, p = 0.009). In conclusion, placing a prophylactic abdominal drainage tube after hepatobiliary surgery does not reduce postoperative infection rates compared with no drainage.

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Section: Discussionmentioning

confidence: 99%

The effect of placing prophylactic abdominal drainage tube after hepatobiliary surgery on postoperative infection: A systematic review and meta‐analysis

Liang,

Liu,

Liu

et al. 2024

International Wound Journal

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“…Subgroup analysis in one of these studies even demonstrated no significant difference in terms of clinical outcomes or complications for patients undergoing acute drainage within 14 days of surgery [17]. These results were then replicated in dedicated studies comparing acute EUSguided drainage within two weeks of surgery to those performed after two weeks [18,19]. These studies are summarised in Table 2 below.…”

Section: Timing For Pofc Drainagementioning

confidence: 90%

“…EUS-guided drainage in some of these studies was performed within two weeks of surgery and sometimes even as early as three days after surgery [19]. These studies are limited by their retrospective nature, small sample sizes, and potential for selection bias [7,[16][17][18][19]23,24]. In addition, three out of the five studies comparing early and delayed EUS-guided drainage did not report the size of the POFC prior to drainage, and none of the studies provided details of the patients' condition prior to intervention.…”

Section: Discussion and Recommendationsmentioning

confidence: 99%

“…The most common type of stent inserted for POFC drainage is a double-pigtail plastic stent (DPPS). Out of 19 studies reviewed (see Table 4), 15 studies had between one and three 7-10-French DPPSs inserted as the initial form of drainage for some or all of their patients [2][3][4]6,7,9,10,[14][15][16][17][18][19]25,26]. Most authors follow a standard protocol for EUS-guided drainage.…”

Section: Type Size and Number Of Stents For Pofc Drainagementioning

confidence: 99%

“…The authors then internalise the drain about one week after the initial procedure. The second method is the selective use of nasocystic drains only if there was necrotic debris or purulent fluid with poor drainage [10,15,18,19,26]. The routine use of nasocystic drains runs counter to the original intention of EUS-guided drainage to reduce external drains and their associated problems.…”

Section: The Use Of Nasocystic Drainage and Irrigationmentioning

confidence: 99%

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The Role of EUS-Guided Drainage in the Management of Postoperative Fluid Collections after Pancreatobiliary Surgery

Ong

Chong

2021

Gastroenterology Insights

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Postoperative fluid collection (POFC) is a challenging complication following pancreatobiliary surgery. Traditional treatment with surgical drainage is associated with significant morbidity, while percutaneous drainage is associated with a higher rate of recurrence and the need for repeated interventions. Studies have shown that endoscopic ultrasound (EUS)-guided drainage may offer a promising solution to this problem. There are limited data on the ideal therapeutic protocol for EUS-guided drainage of POFC including the timing for drainage; type, size, and number of stents to use; and the need for endoscopic debridement and irrigation. Current practices extrapolated from the treatment of pancreatic pseudocysts and walled-off necrosis may not be applicable to POFC. There are increasing data to suggest that drainage procedures may be performed within two weeks after surgery. While most authors advocate the use of double pigtail plastic stents (DPPSs), there have been a number of reports on the use of novel lumen-apposing metal stents (LAMSs), although no direct comparisons have been made between the two.

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Endoskopisches Komplikationsmanagement im hepatobiliopankreatischen System und Tracheobronchialbaum

Kouladouros

Kähler²

2022

Chirurgie

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Effectiveness of early endoscopic ultrasound-guided drainage for postoperative fluid collection

Cited by 6 publications

References 26 publications

The effect of placing prophylactic abdominal drainage tube after hepatobiliary surgery on postoperative infection: A systematic review and meta‐analysis

The effect of placing prophylactic abdominal drainage tube after hepatobiliary surgery on postoperative infection: A systematic review and meta‐analysis

The Role of EUS-Guided Drainage in the Management of Postoperative Fluid Collections after Pancreatobiliary Surgery

Endoskopisches Komplikationsmanagement im hepatobiliopankreatischen System und Tracheobronchialbaum

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