PMID- 27460390
OWN - NLM
STAT- MEDLINE
DCOM- 20170914
LR  - 20171030
IS  - 1097-6779 (Electronic)
IS  - 0016-5107 (Linking)
VI  - 85
IP  - 1
DP  - 2017 Jan
TI  - An international multicenter study comparing EUS-guided pancreatic duct drainage 
      with enteroscopy-assisted endoscopic retrograde pancreatography after Whipple 
      surgery.
PG  - 170-177
LID - S0016-5107(16)30382-0 [pii]
LID - 10.1016/j.gie.2016.07.031 [doi]
AB  - BACKGROUND AND AIMS: Endoscopic management of post-Whipple pancreatic adverse 
      events (AEs) with enteroscopy-assisted endoscopic retrograde pancreatography 
      (e-ERP) is associated with high failure rates. EUS-guided pancreatic duct 
      drainage (EUS-PDD) has shown promising results; however, no comparative data have 
      been done for these 2 modalities. The goal of this study is to compare EUS-PDD 
      with e-ERP in terms of technical success (PDD through dilation/stent), clinical 
      success (improvement/resolution of pancreatic-type symptoms), and AE rates in 
      patients with post-Whipple anatomy. METHODS: This is an international multicenter 
      comparative retrospective study at 7 tertiary centers (2 United States, 2 
      European, 2 Asian, and 1 South American). All consecutive patients who underwent 
      EUS-PDD or e-ERP between January 2010 and August 2015 were included. RESULTS: In 
      total, 66 patients (mean age, 57 years; 48% women) and 75 procedures were 
      identified with 40 in EUS-PDD and 35 in e-ERP. Technical success was achieved in 
      92.5% of procedures in the EUS-PDD group compared with 20% of procedures in the 
      e-ERP group (OR, 49.3; P < .001). Clinical success (per patient) was attained in 
      87.5% of procedures in the EUS-PDD group compared with 23.1% in the e-ERP group 
      (OR, 23.3; P < .001). AEs occurred more commonly in the EUS-PDD group (35% vs 
      2.9%, P < .001). However, all AEs were rated as mild or moderate. Procedure time 
      and length of stay were not significantly different between the 2 groups. 
      CONCLUSIONS: EUS-PDD is superior to e-ERP in post-Whipple anatomy in terms of 
      efficacy with acceptable safety. As such, EUS-PDD should be considered as a 
      potential first-line treatment in post-pancreaticoduodenectomy anatomy when 
      necessary expertise is available.
CI  - Copyright (c) 2017 American Society for Gastrointestinal Endoscopy. Published by 
      Elsevier Inc. All rights reserved.
FAU - Chen, Yen-I
AU  - Chen YI
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, 
      Baltimore, Maryland, USA.
FAU - Levy, Michael J
AU  - Levy MJ
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, 
      USA.
FAU - Moreels, Tom G
AU  - Moreels TG
AD  - Division of Gastroenterology and Hepatology, Cliniques Universitaires Saint-Luc, 
      Brussels, Belgium.
FAU - Hajijeva, Gulara
AU  - Hajijeva G
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, 
      Baltimore, Maryland, USA.
FAU - Will, Uwe
AU  - Will U
AD  - Division of Gastroenterology and Hepatology, Municipal Hospital, Gera, Germany.
FAU - Artifon, Everson L
AU  - Artifon EL
AD  - Department of Surgery, Ana Costa Hospital, Santos, Brazil.
FAU - Hara, Kazuo
AU  - Hara K
AD  - Division of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan.
FAU - Kitano, Masayuki
AU  - Kitano M
AD  - Divisions of Gastroenterology and Hepatology, Kinki University Faculty of 
      Medicine, Osaka, Japan.
FAU - Topazian, Mark
AU  - Topazian M
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, 
      USA.
FAU - Abu Dayyeh, Barham
AU  - Abu Dayyeh B
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, 
      USA.
FAU - Reichel, Andreas
AU  - Reichel A
AD  - Division of Gastroenterology and Hepatology, Municipal Hospital, Gera, Germany.
FAU - Vilela, Tiago
AU  - Vilela T
AD  - Department of Surgery, Ana Costa Hospital, Santos, Brazil.
FAU - Ngamruengphong, Saowanee
AU  - Ngamruengphong S
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, 
      Baltimore, Maryland, USA.
FAU - Haito-Chavez, Yamile
AU  - Haito-Chavez Y
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, 
      Baltimore, Maryland, USA.
FAU - Bukhari, Majidah
AU  - Bukhari M
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, 
      Baltimore, Maryland, USA.
FAU - Okolo, Patrick 3rd
AU  - Okolo P 3rd
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, 
      Baltimore, Maryland, USA.
FAU - Kumbhari, Vivek
AU  - Kumbhari V
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, 
      Baltimore, Maryland, USA.
FAU - Ismail, Amr
AU  - Ismail A
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, 
      Baltimore, Maryland, USA.
FAU - Khashab, Mouen A
AU  - Khashab MA
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, 
      Baltimore, Maryland, USA.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
DEP - 20160725
PL  - United States
TA  - Gastrointest Endosc
JT  - Gastrointestinal endoscopy
JID - 0010505
SB  - IM
CIN - Gastrointest Endosc. 2017 Jan;85(1):178-180. PMID: 27986109
CIN - Gastrointest Endosc. 2017 Oct;86(4):747-748. PMID: 28917352
CIN - Gastrointest Endosc. 2017 Oct;86(4):748-749. PMID: 28917353
MH  - Adult
MH  - Aged
MH  - Anastomosis, Surgical/adverse effects
MH  - Cholangiopancreatography, Endoscopic Retrograde/adverse effects/*methods
MH  - Constriction, Pathologic/etiology/therapy
MH  - Dilatation
MH  - Drainage/adverse effects/*methods
MH  - Endoscopy, Gastrointestinal
MH  - Endosonography
MH  - Female
MH  - Humans
MH  - Length of Stay
MH  - Male
MH  - Middle Aged
MH  - Operative Time
MH  - Pancreatic Ducts/*pathology/*surgery
MH  - Pancreaticoduodenectomy/*adverse effects
MH  - Postoperative Complications/etiology/*therapy
MH  - Retrospective Studies
MH  - Stents
MH  - Treatment Outcome
MH  - Ultrasonography, Interventional/adverse effects
EDAT- 2016/07/28 06:00
MHDA- 2017/09/15 06:00
CRDT- 2016/07/28 06:00
PHST- 2016/03/18 00:00 [received]
PHST- 2016/07/01 00:00 [accepted]
PHST- 2016/07/28 06:00 [pubmed]
PHST- 2017/09/15 06:00 [medline]
PHST- 2016/07/28 06:00 [entrez]
AID - S0016-5107(16)30382-0 [pii]
AID - 10.1016/j.gie.2016.07.031 [doi]
PST - ppublish
SO  - Gastrointest Endosc. 2017 Jan;85(1):170-177. doi: 10.1016/j.gie.2016.07.031. Epub 
      2016 Jul 25.