PMID- 37702186
OWN - NLM
STAT- Publisher
LR  - 20231018
IS  - 1443-1661 (Electronic)
IS  - 0915-5635 (Linking)
DP  - 2023 Sep 13
TI  - Risk factors for adverse outcomes at various phases of endoscopic 
      ultrasound-guided treatment of pancreatic fluid collections: Data from a 
      multi-institutional consortium.
LID - 10.1111/den.14683 [doi]
AB  - OBJECTIVES: No comprehensive study has examined short- and long-term adverse 
      outcomes of endoscopic ultrasound (EUS)-guided treatment of pancreatic fluid 
      collections (PFCs) including walled-off necrosis (WON) and pseudocysts. METHODS: 
      In a multi-institutional cohort of 357 patients receiving EUS-guided treatment of 
      PFCs (228 with WON and 129 with pseudocysts), we examined PFC type-specific risk 
      factors for procedure-related adverse events (AEs), clinical failure, and 
      recurrence. Odds ratios (ORs) and hazard ratios (HRs) with 95% confidence 
      intervals (CIs) were computed using the logistic and Cox regression models, 
      respectively, adjusting for potential confounders. RESULTS: Adverse events were 
      observed predominantly in WON, and risk factors were WON extension to the pelvis 
      (OR 2.49; 95% CI 1.00-6.19) and endoscopic necrosectomy (OR 5.15; 95% CI 
      1.61-16.5). Risk factors for clinical failure in WON treatment included higher 
      Charlson Comorbidity Index (OR for >/=3 vs. </=2, 2.58; 95% CI 1.05-6.35), extension 
      to the pelvis (OR 3.63; 95% CI 1.57-8.43), nonuse of a lumen-apposing metal stent 
      (OR 2.88; 95% CI 1.10-7.54), and percutaneous drainage (OR 3.73; 95% CI 
      1.27-10.9). Patients with pseudocysts extending to the paracolic gutter and the 
      need for more than two endoscopic/percutaneous procedures had ORs for clinical 
      failure of 5.28 (95% CI 1.10-25.3) and 5.52 (95% CI 1.61-18.9), respectively. 
      Pseudocysts requiring the multigateway approach were associated with a high risk 
      of recurrence (HR 4.00; 95% CI 1.11-11.6). CONCLUSION: The adverse outcomes at 
      various phases of EUS-guided PFC treatment may be predictable based on clinical 
      parameters. Further research is warranted to optimize treatment strategies for 
      high-risk patients.
CI  - (c) 2023 The Authors. Digestive Endoscopy published by John Wiley & Sons Australia, 
      Ltd on behalf of Japan Gastroenterological Endoscopy Society.
FAU - Saito, Tomotaka
AU  - Saito T
AUID- ORCID: 0000-0001-6008-1648
AD  - Department of Gastroenterology, Graduate School of Medicine, The University of 
      Tokyo, Tokyo, Japan.
FAU - Omoto, Shunsuke
AU  - Omoto S
AUID- ORCID: 0000-0001-7291-3608
AD  - Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai 
      University, Osaka, Japan.
FAU - Takenaka, Mamoru
AU  - Takenaka M
AUID- ORCID: 0000-0001-7308-4311
AD  - Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai 
      University, Osaka, Japan.
FAU - Tsujimae, Masahiro
AU  - Tsujimae M
AD  - Division of Gastroenterology, Department of Internal Medicine, Kobe University 
      Graduate School of Medicine, Hyogo, Japan.
FAU - Masuda, Atsuhiro
AU  - Masuda A
AD  - Division of Gastroenterology, Department of Internal Medicine, Kobe University 
      Graduate School of Medicine, Hyogo, Japan.
FAU - Sato, Tatsuya
AU  - Sato T
AD  - Department of Gastroenterology, Graduate School of Medicine, The University of 
      Tokyo, Tokyo, Japan.
FAU - Hamada, Tsuyoshi
AU  - Hamada T
AUID- ORCID: 0000-0002-3937-2755
AD  - Department of Gastroenterology, Graduate School of Medicine, The University of 
      Tokyo, Tokyo, Japan.
AD  - Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of 
      Japanese Foundation for Cancer Research, Tokyo, Japan.
FAU - Ota, Shogo
AU  - Ota S
AD  - Division of Gastroenterology and Hepatobiliary and Pancreatic Diseases, 
      Department of Internal Medicine, Hyogo Medical University, Hyogo, Japan.
FAU - Shiomi, Hideyuki
AU  - Shiomi H
AUID- ORCID: 0000-0002-7461-8538
AD  - Division of Gastroenterology and Hepatobiliary and Pancreatic Diseases, 
      Department of Internal Medicine, Hyogo Medical University, Hyogo, Japan.
FAU - Takahashi, Sho
AU  - Takahashi S
AD  - Department of Gastroenterology, Graduate School of Medicine, Juntendo University, 
      Tokyo, Japan.
FAU - Fujisawa, Toshio
AU  - Fujisawa T
AUID- ORCID: 0000-0001-7367-0767
AD  - Department of Gastroenterology, Graduate School of Medicine, Juntendo University, 
      Tokyo, Japan.
FAU - Nakagawa, Keito
AU  - Nakagawa K
AD  - Department of Gastroenterology and Hepatology, Saitama Medical Center, Saitama 
      Medical University, Saitama, Japan.
FAU - Matsubara, Saburo
AU  - Matsubara S
AUID- ORCID: 0000-0001-8182-3524
AD  - Department of Gastroenterology and Hepatology, Saitama Medical Center, Saitama 
      Medical University, Saitama, Japan.
FAU - Uemura, Shinya
AU  - Uemura S
AD  - First Department of Internal Medicine, Gifu University Hospital, Gifu, Japan.
FAU - Iwashita, Takuji
AU  - Iwashita T
AUID- ORCID: 0000-0003-4978-1787
AD  - First Department of Internal Medicine, Gifu University Hospital, Gifu, Japan.
FAU - Yoshida, Kensaku
AU  - Yoshida K
AUID- ORCID: 0000-0001-8936-1248
AD  - Department of Gastroenterology, Gifu Prefectural General Medical Center, Gifu, 
      Japan.
FAU - Maruta, Akinori
AU  - Maruta A
AD  - Department of Gastroenterology, Gifu Prefectural General Medical Center, Gifu, 
      Japan.
FAU - Okuno, Mitsuru
AU  - Okuno M
AUID- ORCID: 0000-0001-8989-6437
AD  - Department of Gastroenterology, Gifu Municipal Hospital, Gifu, Japan.
FAU - Iwata, Keisuke
AU  - Iwata K
AD  - Department of Gastroenterology, Gifu Municipal Hospital, Gifu, Japan.
FAU - Hayashi, Nobuhiko
AU  - Hayashi N
AD  - Third Department of Internal Medicine, University of Toyama, Toyama, Japan.
FAU - Mukai, Tsuyoshi
AU  - Mukai T
AD  - Department of Gastroenterological Endoscopy, Kanazawa Medical University, 
      Ishikawa, Japan.
FAU - Isayama, Hiroyuki
AU  - Isayama H
AUID- ORCID: 0000-0002-3308-9326
AD  - Department of Gastroenterology, Graduate School of Medicine, Juntendo University, 
      Tokyo, Japan.
FAU - Yasuda, Ichiro
AU  - Yasuda I
AUID- ORCID: 0000-0002-6888-0310
AD  - Third Department of Internal Medicine, University of Toyama, Toyama, Japan.
FAU - Nakai, Yousuke
AU  - Nakai Y
AUID- ORCID: 0000-0001-7411-1385
AD  - Department of Gastroenterology, Graduate School of Medicine, The University of 
      Tokyo, Tokyo, Japan.
AD  - Department of Endoscopy and Endoscopic Surgery, The University of Tokyo Hospital, 
      Tokyo, Japan.
CN  - WONDERFUL study group in Japan
LA  - eng
GR  - Research Grant B / #1015/Japanese Foundation for Research and Promotion of 
      Endoscopy/
PT  - Journal Article
DEP - 20230913
PL  - Australia
TA  - Dig Endosc
JT  - Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy 
      Society
JID - 9101419
SB  - IM
OTO - NOTNLM
OT  - cohort study
OT  - endoscopy
OT  - endosonography
OT  - pancreatitis
OT  - stent
FIR - Sakai, Arata
IR  - Sakai A
FIR - Nakano, Ryota
IR  - Nakano R
FIR - Iwata, Shota
IR  - Iwata S
FIR - Iwasa, Yuhei
IR  - Iwasa Y
EDAT- 2023/09/13 06:42
MHDA- 2023/09/13 06:42
CRDT- 2023/09/13 05:43
PHST- 2023/06/12 00:00 [received]
PHST- 2023/09/10 00:00 [accepted]
PHST- 2023/09/13 06:42 [pubmed]
PHST- 2023/09/13 06:42 [medline]
PHST- 2023/09/13 05:43 [entrez]
AID - 10.1111/den.14683 [doi]
PST - aheadofprint
SO  - Dig Endosc. 2023 Sep 13. doi: 10.1111/den.14683.