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

Published on Aug 1, 2011in Gastrointestinal Endoscopy7.229
· DOI :10.1016/J.GIE.2011.03.1242
Shyam Varadarajulu45
Estimated H-index: 45
(UAB: University of Alabama at Birmingham),
C. Mel Wilcox50
Estimated H-index: 50
(UAB: University of Alabama at Birmingham),
John D. Christein31
Estimated H-index: 31
(UAB: University of Alabama at Birmingham)
  • References (9)
  • Citations (25)
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Background Peripancreatic fluid collections (PFCs) are a common complication after distal pancreatectomy and are usually managed by percutaneous drainage. The role of EUS in the management of postoperative PFCs has not been previously reported. Objective To evaluate the role of EUS in the management of PFCs after distal pancreatectomy. Study Design Case series. Setting Academic tertiary referral center. Patients Symptomatic patients with PFCs after a distal pancreatectomy. Interventions At EUS, ...
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Background Although several large series have reported on EUS-guided transgastric and transduodenal drainage of peripancreatic fluid collections (PFCs), only commentary on individual cases has been presented on EUS-guided transesophageal drainage of PFCs. Objective To evaluate the technical success and safety of EUS-guided transesophageal drainage of PFCs. Design Observational study. Setting Tertiary academic referral center. Patients This study involved 3 consecutive patients referred for EUS-g...
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A postoperative pancreatic fistula (POPF) is One of the most common complications after left-sided pancreatectomy and has traditionally been a source of significant morbidity.1–4 Using the criteria proposed by the International Study Group on Pancreatic Fistula (ISGPF), recent series have demonstrated an incidence of POPF after left-sided pancreatectomy ranging between 22 and 31 per cent.3–6 Although many POPF quickly resolve without medical therapy or invasive intervention (Grade A), approximat...
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Objective To critically analyze a large single-institution experience with distal pancreatectomy (DP), with particular attention to the risk factors, outcome, and management of the postoperative pancreatic fistula (PF). Design Retrospective study. Setting Tertiary referral center. Patients A total of 232 consecutive patients with pancreatic or extrapancreatic disease necessitating DP over 21 years. Interventions Twenty-one patients underwent spleen-preserving DP, 117 underwent DP with splenectom...
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Background Anastomotic fistula, leak, and abscess are common complications of pancreatectomy. The goal of this study was to describe our current management and outcomes of clinically significant postpancreatectomy fistula, leak, and abscess. Study Design Review of a prospectively maintained database identified 908 patients who underwent pancreatectomy between January 2000 and August 2005. Complication data were prospectively entered into a validated postoperative complication database. Patients ...
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Hypothesis Experience with pancreatic resection for the last 10 years has resulted in new trends in patient characteristics and, for pancreaticoduodenectomy (PD), a decrease in the length of stay (LOS). This decrease is due in part to the implementation of case management and clinical pathways. Design Retrospective case series of patients undergoing pancreatic resection. Setting A university-affiliated, tertiary care referral center. Patients The study comprised 733 consecutive patients undergoi...
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PURPOSE: To assess the relationship between the cause and severity of pancreatitis and the development of persistent pancreatocutaneous fistula (PPCF) after percutaneous drainage of pancreatic fluid collections. MATERIALS AND METHODS: Sixty patients (44 male, 16 female; age range, 10–74 years) were included in the study. The cause of pancreatitis was postoperative in 29 patients, alcoholism in 20 patients, biliary in six patients, hyperlipidemia in two patients, unknown in two patients, and trau...
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Distal pancreatectomy is a term applied to resection of that portion of the pancreas extending to the left of the midline and not including the duodenum and distal bile duct. Distal pancreatectomy is performed for various indications, including benign inflammatory conditions and benign and malignant neoplasms. In the past decade, pancreaticoduodenectomy, or resection of the head of the pancreas, has been performed with increased frequency because of a marked reduction in procedure-related morbid...
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The advent of lumen apposing metal stents (LAMS) has revolutionized the management of many complex gastroenterological conditions that previously required surgical or radiological interventions. These procedures have garnered popularity due to their minimally invasive nature, higher technical and clinical success rate and lower rate of adverse events. By virtue of their unique design, LAMS provide more efficient drainage, serve as conduit for endoscopic access, are associated with lower rates of...
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Abstract Background and Aims EUS-guided drainage (EUS-POD) of postoperative fluid collections (POFCs) is typically delayed until a thick wall has formed to optimize safety. Thus, percutaneous drainage is the mainstay of early POFC management. The primary aim of this study was to compare technical and clinical success and adverse event (AE) rate between early (0-30 days postoperative) compared with delayed (>30 days) EUS-POD. The secondary aim was to determine predictors for clinical success and ...
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: Endoscopic ultrasound (EUS)-guided transgastric drainage has been performed as a less invasive procedure for pancreatic fistulas and intra-abdominal abscesses occurring after surgery in recent years. However, there are no reports of EUS-guided transgastric drainage of intra-abdominal abscesses following gastrectomy. This case report describes 2 patients who developed an intra-abdominal abscess following gastrectomy and underwent EUS-guided transgastric drainage. Both patients underwent laparos...
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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 exclude...
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Background Multiple studies have examined the use of lumen-apposing metal stents (LAMSs) for the drainage of peripancreatic fluid collections. Data on the use of LAMSs for postoperative fluid collections (POFCs) are scarce. POFCs may lead to severe complications without appropriate treatment. We aimed to study the outcomes (technical success, clinical success, rate/severity of adverse events, length of stay, recurrence) of the use of LAMSs for the drainage of POFCs. Methods This international, m...
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Abstract 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 ...
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Background and Aims Postoperative pancreatic leakage and fistulae (POPF) are a leading adverse event after partial pancreatic resection. Treatment algorithms are currently not standardized. Evidence regarding the role of endoscopy is scarce. Methods One hundred ninety-six POPF patients with (n = 132) and without (n = 64) concomitant pancreatic fluid collections (PFCs) from centers in Berlin, Kiel, and Dresden were analyzed retrospectively. Clinical resolution was used as the primary endpoint of ...
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Lumen-apposing metal stents (LAMS) use in gastrointestinal endoscopy has been on the rise for various indications for the last few years. Currently, LAMS is a well-established treatment for post-pancreatitis peri-pancreatic fluid collections and walled-off necrosis (WON), but it is still not a standard of care in the treatment of post-surgical fluid collections (PSFC). Most of the earlier studies for treatment of PSFC utilized double pigtail plastic stents (DPS). We present a series of 3 cases w...