Efficacy and safety of endoscopic ultrasound-guided drainage of pancreatic pseudocysts using double-pigtail plastic stents: A single tertiary center experience
Abstract:OBJECTIVES:
Pancreatic pseudocysts (PPC) are fluid collections with a well-defined wall that persist for more than 4 weeks inside or around the pancreas as a result of pancreatic inflammation and/or a ductal lesion. PPC have been successfully treated with endoscopic ultrasound (EUS)-guided drainage using different stents. This study aimed to evaluate the safety and efficacy of EUS-guided drainage of PPC using double-pigtail plastic stents in a tertiary hospital.
METHODS:
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Background
Acid-suppressing drugs affect intestinal microbes by inhibiting the secretion of stomach acid. However, it is not clear whether acid suppressive drugs affect the microorganisms in the peripancreatic effusion and affect the postoperative complications.
Methods
This study was a prospective randomized controlled trial. A total of 45 patients were enrolled in the trial, and all patients were divided into acid-inhibited and non-inhibited groups. The primary endpoint of our study was to observe the difference of microbiota in the two groups of cyst fluid.
Results
A total of 25 patients were included in the acid-inhibited group and 20 patients were included in the non-acid-inhibited group. There were no significant differences between the two groups in terms of postoperative infection, bleeding, and recurrence rates (p > 0.05). In terms of postoperative C-reactive protein levels, the acid-suppressing group was significantly higher than the non-acid-suppressing group (p < 0.05). In the 16S microbial sequencing analysis, we found no significant difference in α diversity between the antibiotic group and the non-antibiotic group, but there was a statistically significant difference in β diversity between the two groups
Conclusion
Acid-suppressing drugs can change the microbial composition of pancreatic effusions and increase markers of postoperative inflammation. Acid-suppressive drugs may increase the potential infection after endoscopic drainage.
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