Efficacy of endoscopic ultrasound‐guided abscess drainage for non‐pancreatic abscesses: A retrospective study

Abstract

Background and Aim Percutaneous drainage of intra‐abdominal abscesses is often uncomfortable for the patient and may result in prolonged hospital stays. Recent studies have shown that endoscopic ultrasound‐guided abscess drainage (EUS‐AD) could effectively treat various abscesses and fluid collections. However, no indications or procedures have been established for EUS‐AD treatments, and studies on its usefulness and safety are insufficient. The present study aimed to evaluate the efficacy and safety of EUS‐AD for treating non‐pancreatic abscesses. Methods This retrospective study included 20 patients, aged ≥20 years, who underwent EUS‐AD for an abscess or fluid accumulation in the abdomen or mediastinum, but not the pancreas. Patients were treated at the Kawasaki University General Medical Center between March 2013 and June 2021. All EUS‐AD procedures were performed prior to a percutaneous drainage or surgical drainage. Results Among the 20 patients who underwent an EUS‐AD for abscess, 8 (40%) had liver abscesses, 6 (30%) had intraperitoneal abscesses, 3 had (15%) splenic abscesses, 1 (5%) had a mediastinal abscess, 1 (5%) had an iliopsoas abscess (n = 1, 5%), and 1 (5%) had an abdominal wall abscess. The technical success rate was 95% (n = 19/20). We inserted nasobiliary catheters in 4/20 patients (20%). The clinical success rate was 90% (n = 18/20). Two clinical failures required reintervention, and both were treated with percutaneous drainage. Adverse events were observed in 2/20 patients (10%). One patient experienced fever after the procedure, and the other experienced localized peritonitis. Conclusion EUS‐AD was effective and safe for abscess removal, particularly when approached from the upper gastrointestinal tract.