PMID- 37322361
OWN - NLM
STAT- MEDLINE
DCOM- 20230831
LR  - 20230910
IS  - 1432-2218 (Electronic)
IS  - 0930-2794 (Linking)
VI  - 37
IP  - 9
DP  - 2023 Sep
TI  - Endoscopic ultrasound-guided versus percutaneous drainage for the management of 
      post-operative fluid collections after distal pancreatectomy.
PG  - 6922-6929
LID - 10.1007/s00464-023-10188-6 [doi]
AB  - BACKGROUND: Post-operative pancreatic fluid collections (POPFCs) can be drained 
      using percutaneous or endoscopic approaches. The primary aim of this study was to 
      compare rates of clinical success between endoscopic ultrasound-guided drainage 
      (EUSD) with percutaneous drainage (PTD) in the management of symptomatic POPFCs 
      after distal pancreatectomy. Secondary outcomes included technical success, total 
      number of interventions, time to resolution, rates of adverse events (AEs), and 
      POPFC recurrence. METHODS: Adults who underwent distal pancreatectomy from 
      January 2012 to August 2021 and developed symptomatic POPFC in the resection bed 
      were retrospectively identified from a single academic center database. 
      Demographic data, procedural data, and clinical outcomes were abstracted. 
      Clinical success was defined as symptomatic improvement and radiographic 
      resolution without requiring an alternate drainage modality. Quantitative 
      variables were compared using a two-tailed t-test and categorical data were 
      compared using Chi-squared or Fisher's exact tests. RESULTS: Of 1046 patients 
      that underwent distal pancreatectomy, 217 met study inclusion criteria (median 
      age 60 years, 51.2% female), of whom 106 underwent EUSD and 111 PTD. There were 
      no significant differences in baseline pathology and POPFC size. PTD was 
      generally performed earlier after surgery (10 vs. 27 days; p < 0.001) and more 
      commonly in the inpatient setting (82.9% vs. 49.1%; p < 0.001). EUSD was 
      associated with a significantly higher rate of clinical success (92.5% vs. 76.6%; 
      p = 0.001), fewer median number of interventions (2 vs. 4; p < 0.001), and lower 
      rate of POPFC recurrence (7.6% vs. 20.7%; p = 0.007). AEs were similar between 
      EUSD (10.4%) and PTD (6.3%, p = 0.28), with approximately one-third of EUSD AEs 
      due to stent migration. CONCLUSION: In patients with POPFCs after distal 
      pancreatectomy, delayed drainage with EUSD was associated with higher rates of 
      clinical success, fewer interventions, and lower rates of recurrence than earlier 
      drainage with PTD.
CI  - (c) 2023. The Author(s), under exclusive licence to Springer Science+Business 
      Media, LLC, part of Springer Nature.
FAU - Fogwe, Delvise T
AU  - Fogwe DT
AD  - Department of Internal Medicine, Mayo Clinic, Rochester, USA.
FAU - AbiMansour, Jad P
AU  - AbiMansour JP
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, 
      Rochester, MN, 55905, USA.
FAU - Truty, Mark J
AU  - Truty MJ
AD  - Division of Hepatobiliary and Pancreatic Surgery, Mayo Clinic, Rochester, USA.
FAU - Levy, Michael J
AU  - Levy MJ
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, 
      Rochester, MN, 55905, USA.
FAU - Storm, Andrew C
AU  - Storm AC
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, 
      Rochester, MN, 55905, USA.
FAU - Law, Ryan J
AU  - Law RJ
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, 
      Rochester, MN, 55905, USA.
FAU - Vargas, Eric J
AU  - Vargas EJ
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, 
      Rochester, MN, 55905, USA.
FAU - Fleming, Chad J
AU  - Fleming CJ
AD  - Division of Vascular and Interventional Radiology, Mayo Clinic, Rochester, USA.
FAU - Andrews, James C
AU  - Andrews JC
AD  - Division of Vascular and Interventional Radiology, Mayo Clinic, Rochester, USA.
FAU - Cleary, Sean P
AU  - Cleary SP
AD  - Division of Hepatobiliary and Pancreatic Surgery, Mayo Clinic, Rochester, USA.
FAU - Kendrick, Michael L
AU  - Kendrick ML
AD  - Division of Hepatobiliary and Pancreatic Surgery, Mayo Clinic, Rochester, USA.
FAU - Martin, John A
AU  - Martin JA
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, 
      Rochester, MN, 55905, USA.
FAU - Bofill-Garcia, Aliana M
AU  - Bofill-Garcia AM
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, 
      Rochester, MN, 55905, USA.
FAU - Dayyeh, Barham K Abu
AU  - Dayyeh BKA
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, 
      Rochester, MN, 55905, USA.
FAU - Chandrasekhara, Vinay
AU  - Chandrasekhara V
AUID- ORCID: 0000-0001-6209-9905
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, 
      Rochester, MN, 55905, USA. Chandrasekhara.Vinay@mayo.edu.
LA  - eng
PT  - Journal Article
DEP - 20230615
PL  - Germany
TA  - Surg Endosc
JT  - Surgical endoscopy
JID - 8806653
SB  - IM
MH  - Adult
MH  - Humans
MH  - Female
MH  - Middle Aged
MH  - Male
MH  - *Pancreatectomy
MH  - Retrospective Studies
MH  - Postoperative Complications/etiology/surgery
MH  - Drainage
MH  - Endosonography
MH  - *Pancreatic Diseases/surgery
MH  - Ultrasonography, Interventional
MH  - Treatment Outcome
OTO - NOTNLM
OT  - EUS-guided drainage
OT  - Pancreatectomy
OT  - Percutaneous
OT  - Post-operative fluid collection
EDAT- 2023/06/16 01:08
MHDA- 2023/08/31 06:41
CRDT- 2023/06/15 23:33
PHST- 2022/11/25 00:00 [received]
PHST- 2023/05/30 00:00 [accepted]
PHST- 2023/08/31 06:41 [medline]
PHST- 2023/06/16 01:08 [pubmed]
PHST- 2023/06/15 23:33 [entrez]
AID - 10.1007/s00464-023-10188-6 [pii]
AID - 10.1007/s00464-023-10188-6 [doi]
PST - ppublish
SO  - Surg Endosc. 2023 Sep;37(9):6922-6929. doi: 10.1007/s00464-023-10188-6. Epub 2023 
      Jun 15.