TY - JOUR
T1 - Endoscopic versus percutaneous drainage of post-operative peripancreatic fluid collections following pancreatic resection
AU - Al Efishat, Mohammad
AU - Attiyeh, Marc A.
AU - Eaton, Anne A.
AU - Gönen, Mithat
AU - Covey, Anne M.
AU - D'Angelica, Michael I.
AU - DeMatteo, Ronald P.
AU - Kingham, T. Peter
AU - Balachandran, Vinod
AU - Jarnagin, William R.
AU - Gerdes, Hans
AU - Allen, Peter J.
AU - Schattner, Mark A.
N1 - Funding Information:
Supported in part by Marshall and Therese Sonenshine Foundation .
PY - 2019/4
Y1 - 2019/4
N2 - Background: Post-operative peripancreatic fluid collection (PFC) is a common complication following pancreatic resection which can be managed with endoscopic or percutaneous drainage. Methods: Patients who underwent either endoscopic or percutaneous drainage of post-operative PFC were extracted from a prospectively-maintained database. The two groups were matched for surgery type, presence of a surgical drain and timing of drainage. Results: Thirty-nine matched patients were identified in each group with a median age of 62 years. For primary drainage, technical success was achieved in almost all patients in both endoscopic and percutaneous groups (100% and 97%, p = NS); clinical success was achieved in 67% and 59%, respectively (p = 0.63). At least one “salvage” drainage procedure was required in 13 endoscopic patients versus 16 in the percutaneous group. Clinical success was achieved following the first salvage. Procedure in 85% of the endoscopic patients and 88% of the percutaneous patients (p = 0.62). Stent/drain duration (59 vs 33 days, p < 0.001) and number of post-procedural CT studies (2 vs 1, p = 0.02) were significantly higher in the endoscopic group. There was no difference in length of stay, complication, or recurrence between the two groups. Conclusion: Endoscopic drainage of post-operative PFC appears to be safe and effective with comparable success rates and outcomes to percutaneous drainage.
AB - Background: Post-operative peripancreatic fluid collection (PFC) is a common complication following pancreatic resection which can be managed with endoscopic or percutaneous drainage. Methods: Patients who underwent either endoscopic or percutaneous drainage of post-operative PFC were extracted from a prospectively-maintained database. The two groups were matched for surgery type, presence of a surgical drain and timing of drainage. Results: Thirty-nine matched patients were identified in each group with a median age of 62 years. For primary drainage, technical success was achieved in almost all patients in both endoscopic and percutaneous groups (100% and 97%, p = NS); clinical success was achieved in 67% and 59%, respectively (p = 0.63). At least one “salvage” drainage procedure was required in 13 endoscopic patients versus 16 in the percutaneous group. Clinical success was achieved following the first salvage. Procedure in 85% of the endoscopic patients and 88% of the percutaneous patients (p = 0.62). Stent/drain duration (59 vs 33 days, p < 0.001) and number of post-procedural CT studies (2 vs 1, p = 0.02) were significantly higher in the endoscopic group. There was no difference in length of stay, complication, or recurrence between the two groups. Conclusion: Endoscopic drainage of post-operative PFC appears to be safe and effective with comparable success rates and outcomes to percutaneous drainage.
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U2 - 10.1016/j.hpb.2018.08.010
DO - 10.1016/j.hpb.2018.08.010
M3 - Article
C2 - 30293867
AN - SCOPUS:85054157207
VL - 21
SP - 434
EP - 443
JO - HPB
JF - HPB
SN - 1365-182X
IS - 4
ER -