Endoscopic ultrasonography‐guided drainage of postoperative abdominal fluid collections: What should we do to improve outcomes?

Bang, Ji Young; Varadarajulu, Shyam

doi:10.1111/den.12492

Cited by 4 publications

(2 citation statements)

References 11 publications

(23 reference statements)

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“…Other rare complications include cellulitis surrounding the drain entry, fistula formation, bleeding [6]. In addition, multiloculated and complex collections may need prolonged drainage predisposing to infections, fistulas or may require multiple exchange procedures [15].…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-Guided Percutaneous Drainage of Abdominal Collections—An Analysis over 5 Years

Stan-Ilie

Plotogea

Rinja

et al. 2021

Gastroenterology Insights

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Introduction. Ultrasound-guided (US-guided) percutaneous drainage (PD) of abdominal collections represents the first-choice alternative to surgical intervention. The aim of our study was to assess the efficacy and safety of PD of visceral and non-visceral abdominal collections by reviewing our personal experience over a period of 5 years. Material and methods. The present study included 66 patients who underwent PD under ultrasound guidance. We analyzed clinical variables (collection size, catheter diameter, collection type, microbiological analysis, antibiotic regimens) along with the outcomes of the procedure. Results. Visceral collections were predominant, encompassing 38 hepatic abscesses and 1 splenic hematoma. Microbiological analysis showed that the majority (54%) were monomicrobial. The most encountered pathogens were Klebsiella pneumoniae and Escherichia coli. Technical success was achieved in all cases and clinical success was observed in 84.6% of the cases. No immediate procedural complications were detected. There were 6 patients who needed reinterventions, either by catheter replacement or by surgical treatment. The mortality rate was 4.5%, due to patients’ poor overall status and oncological comorbidities. Conclusions. Percutaneous drainage under ultrasound guidance is a safe and effective procedure in the management of abdominal collections.

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Section: Discussionmentioning

confidence: 99%

Ultrasound-Guided Percutaneous Drainage of Abdominal Collections—An Analysis over 5 Years

Stan-Ilie

Plotogea

Rinja

et al. 2021

Gastroenterology Insights

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“…The utilization of radiological drainage consistently results in a diminished quality of life, primarily attributable to the need for an external drainage system and the increased risk persistent pancreatic stula [8,9]. Additionally, endoscopic ultrasound-guided drainage is not considered a suitable approach for managing uid collections that exhibit limited adherence to the stomach or duodenum, as these cases pose a signi cant risk of perforation and leakage [10]. Currently, there are no drugs that effectively promote the absorption of AFCs.…”

Section: Introductionmentioning

confidence: 99%

Topical application of Glauber’s salt accelerates the absorption of abdominal fluid after pancreatectomy.

Li,

Hua,

Ruan

et al. 2024

Preprint

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Background Abdominal fluid collection (AFC) is one of the most common complications after pancreatic surgery, yet there are few recommendations on how to manage it. Most cases of AFC only require observation, while others may require more invasive techniques. Unfortunately, there are no drugs that effectively promote the absorption of AFCs. The aim of this study was to evaluate the potential efficacy of Glauber's salt solution for promoting the absorption of AFCs after pancreatectomy. Methods This study included 196 patients who underwent pancreatomy and had AFCs on at least 2 cross-sectional follow-up CT images between 2020 and 2022. AFCs were defined as effusion with a diameter ≥ 3 cm and located around the pancreatic resection margin. We retrospectively investigated the relationship between Glauber’s salt concentration and clinical variables. Results The rate of clinically significant pancreatic fistula (grades B + C) was significantly higher in the control group (62.8% vs. 40.7%, P = 0.014). The median maximum diameter of the AFC was smaller, and the median time for the AFC to decrease to 30 mm in diameter was shorter in the Glauber’s salt group than in the control group (41.9 mm vs. 53.5 mm, P = 0.008; 35.5 d vs. 100 d, P < 0.001). According to the multivariate analysis, percutaneous drainage and the application of Glauber’s salt were found to be independent risk factors for AFCs decreasing to less than 30 mm in diameter (HR = 2.338, 95% CI = 1.524–3.585, P < 0.001; HR = 1.853, 95% CI = 1.327–2.589, P < 0.001). Additionally, patients with a maximum postoperative temperature exceeding 38.5°C exhibited enhanced AFC absorption (hazard ratio (HR) = 1.850, 95% CI = 1.268–2.701; P = 0.001). Conclusions Topical application of Glauber's salt solution after pancreatic surgery can promote the absorption of AFCs.

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

Lee

Song

et al. 2021

Surg Endosc

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Endoscopic ultrasonography‐guided drainage of postoperative abdominal fluid collections: What should we do to improve outcomes?

Cited by 4 publications

References 11 publications

Ultrasound-Guided Percutaneous Drainage of Abdominal Collections—An Analysis over 5 Years

Ultrasound-Guided Percutaneous Drainage of Abdominal Collections—An Analysis over 5 Years

Topical application of Glauber’s salt accelerates the absorption of abdominal fluid after pancreatectomy.

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

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