EUS-guided therapy for management of peripancreatic fluid collections after distal pancreatectomy in 20 consecutive patients

Varadarajulu, Shyam; Wilcox, C. Mel; Christein, John D.

doi:10.1016/j.gie.2011.03.1242

Cited by 49 publications

(42 citation statements)

References 9 publications

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“…What lessons can we learn from this study? First, several previous studies have shown that EUS is an excellent modality for drainage of PAFC following pancreatic resections and for drainage of postoperative intra‐abdominal abscesses and, despite the lack of statistical difference, the authors in the present study have suggested that the EUS‐based approach may be more advantageous than percutaneous techniques. Second, the high recurrence rates in both treatment arms suggest that there is room for improvement in treatment outcomes in PAFC, presumably by improving the technique.…”

mentioning

confidence: 77%

“…Also, unlike percutaneous catheters, stents act as a conduit for internal drainage and thereby avoid skin infection, excoriation and cutaneous fistula formation. There is currently a growing body of evidence advocating the use of EUS‐guided techniques for internal drainage of PAFC with high technical and clinical success rates of 96–100% and 89–100%, respectively . However, a major disadvantage is that the PAFC must be located adjacent to the gastrointestinal lumen and within the visual field of the EUS transducer.…”

mentioning

confidence: 99%

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

Bang

Varadarajulu

2015

Digestive Endoscopy

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confidence: 77%

mentioning

confidence: 99%

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

Bang

Varadarajulu

2015

Digestive Endoscopy

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“…One or multiple pigtail biliary stents, at the discretion of the endoscopist, are then placed. Varadarajulu et al recently reported technical and clinical success rate of 100 % with no associated procedural or delayed complications [32]. Compared with percutaneous drainage, EUS-guided drainage offers several potential advantages.…”

Section: Interventional Techniquesmentioning

confidence: 99%

Diagnosis and management of postoperative pancreatic fistula

Malleo

Pulvirenti

Marchegiani

et al. 2014

Langenbecks Arch Surg

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The high incidence of POPF was accompanied by a shift from operative to non-operative management. However, the current management strategy is driven by the patient's condition and local expertise and is generally based on poor evidence. A randomized trial showed that enteral nutrition is superior to total parenteral nutrition, and pooled data of randomized trials failed to show any advantage of somatostatin analogs for accelerating fistula closure. The choice of percutaneous versus endoscopic drainage of peripancreatic collections remains arbitrary, and-when re-operation is needed-there are very few comparative data regarding local drainage with or without main pancreatic stenting as opposed to anastomotic revision or salvage re-anastomosis. The continuous development of specialist, high-volume units with appropriate resources and multidisciplinary experience in complication management might further improve the evidence and the outcomes.

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“…Endoscopic ultrasound‐guided drainage (EUS‐D) theoretically presents the same advantages as percutaneous procedures, whereas it also eliminates the need for an external drain, minimizes the risk of fistulas and prevents fluid and electrolyte losses . Endoscopic ultrasound‐guided drainage has become the standard treatment for peripancreatic fluid collections, and has been successfully used in hepatic abscesses and postsurgical intra‐abdominal collections . The number of available studies evaluating non‐peripancreatic fluid collections is still scarce, and only one of them compares the results obtained with EUS‐D to a cohort of percutaneously drained abscesses …”

Section: Introductionmentioning

confidence: 99%

“…4 Endoscopic ultrasound-guided drainage has become the standard treatment for peripancreatic fluid collections, 5 and has been successfully used in hepatic abscesses [6][7][8][9][10] and postsurgical intra-abdominal collections. [11][12][13] The number of available studies evaluating non-peripancreatic fluid collections is still scarce, and only one of them compares the results obtained with EUS-D to a cohort of percutaneously drained abscesses. 7 In the present study, we compared the efficacy and safety of EUS-guided and PCD of upper abdominal abscesses.…”

Section: Introductionmentioning

confidence: 99%

Retrospective cohort study comparing endoscopic ultrasound‐guided and percutaneous drainage of upper abdominal abscesses

Carbajo

Vegas

García‐Alonso

et al. 2019

Digestive Endoscopy

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Background and Aim Endoscopic ultrasonography (EUS)‐guided drainage (EUS‐D) has become the standard treatment for peripancreatic fluid collections. Its use in other intra‐abdominal abscesses has been reported, although there is limited evidence. Methods We carried out a single‐center retrospective cohort study comparing percutaneous drainage (PCD) and EUS‐D of upper abdominal abscesses between January 2012 and June 2017. Pancreatic fluid collections and liver transplant recipients were excluded. Primary endpoints were technical and clinical success rates. Results We included 18 EUS‐D (nine hepatic and nine intraperitoneal abscesses) and 62 PCD. There were no differences regarding age, gender and etiology. Size was larger in the PCD group (80 vs 65.5 mm, P = 0.04) and perivesicular location was more frequent in the PCD group (24.2% vs 11.1%, P = 0.003). In the EUS‐D group, metal stents were deployed in 16 (88.9%) subjects (eight lumen‐apposing metal stents and eight self‐expandable metal stents), coaxial double‐pigtail plastic stents in six (33.3%) and lavage/debridement was carried out in five (27.8%). There were no significant differences in technical success (EUS‐D: 88.9%, PCD: 96.8%, P = 0.22) or clinical success (EUS‐D: 88.9%, PCD: 82.3%, P = 0.50), with no relapses in the EUS‐D group and 10 (16.1%) in the PCD group (P = 0.11). There were four (22.2%) adverse events in the EUS‐D group, none of them severe, and 13 (21%) in the PCD group (P = 0.91). Conclusions EUS‐D is an alternative to PCD in the treatment of upper abdominal abscesses, reaching similar success, relapse and adverse events rates.

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EUS-guided therapy for management of peripancreatic fluid collections after distal pancreatectomy in 20 consecutive patients

Cited by 49 publications

References 9 publications

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

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

Diagnosis and management of postoperative pancreatic fistula

Retrospective cohort study comparing endoscopic ultrasound‐guided and percutaneous drainage of upper abdominal abscesses

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