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Management of peripancreatic fluid collections following partial pancreatectomy: a comparison of percutaneous versus EUS-guided drainage

Published on Jan 30, 2013in Surgical Endoscopy and Other Interventional Techniques3.209
· DOI :10.1007/S00464-012-2752-Z
Yong M. Kwon1
Estimated H-index: 1
,
Hans Gerdes29
Estimated H-index: 29
(MSK: Memorial Sloan Kettering Cancer Center)
+ 8 AuthorsChristopher J. DiMaio13
Estimated H-index: 13
(ISMMS: Icahn School of Medicine at Mount Sinai)
Abstract
Background Peripancreatic fluid collections (PFCs) occur in up to 30 % of patients following partial pancreatic resections. Traditionally, postoperative PFCs are managed via percutaneous drainage (PD). EUS-guided transgastric drainage has been shown to be effective for the management of PFCs secondary to acute pancreatitis. However, there are limited data on the use of EUS-guided drainage (EUSD) for the management of postoperative PFCs.
  • References (27)
  • Citations (32)
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References27
Newest
#1Shyam Varadarajulu (UAB: University of Alabama at Birmingham)H-Index: 45
#2John D. Christein (UAB: University of Alabama at Birmingham)H-Index: 31
Last. C. M. Wilcox (UAB: University of Alabama at Birmingham)H-Index: 9
view all 3 authors...
Background and Aim: The aim of the present study was to evaluate the frequency of complications during endoscopic ultrasound (EUS)-guided drainage of pancreatic fluid collections (PFC), identify contributing factors, and report on management outcomes. Methods: All patients who underwent EUS-guided PFC drainage over 7 years were enrolled. Indications, demographics, technical details, complications, surgical interventions, and final outcomes were prospectively recorded. Results: Of 148 patients wh...
68 CitationsSource
#1Shyam Varadarajulu (UAB: University of Alabama at Birmingham)H-Index: 45
#2C. Mel Wilcox (UAB: University of Alabama at Birmingham)H-Index: 50
Last. John D. Christein (UAB: University of Alabama at Birmingham)H-Index: 31
view all 3 authors...
25 CitationsSource
#1Shyam Varadarajulu (UAB: University of Alabama at Birmingham)H-Index: 45
#2Ji Young Bang (UAB: University of Alabama at Birmingham)H-Index: 22
Last. C. Mel Wilcox (UAB: University of Alabama at Birmingham)H-Index: 50
view all 5 authors...
Objectives Endoscopy is a minimally invasive technique for the drainage of peripancreatic fluid collections. This study evaluated the clinical outcomes and predictors of treatment success in consecutive patients undergoing endoscopic transmural drainage of peripancreatic fluid collections.
168 CitationsSource
Despite overall improvement in outcomes after pancreatic surgery, the problem of leak continues to challenge surgical specialists. Failure to adequately address this complication can lead to sepsis, hemorrhage, organ failure, and death. Prompt recognition and early intervention are essential. Once fistula output and intra-abdominal infection have been adequately controlled often by percutaneous techniques, successful resolution without the need for re-operation is usually possible.
4 CitationsSource
#1Shiva Jayaraman (MSK: Memorial Sloan Kettering Cancer Center)H-Index: 4
#2Mithat Gonen (MSK: Memorial Sloan Kettering Cancer Center)H-Index: 107
Last. Peter J. Allen (MSK: Memorial Sloan Kettering Cancer Center)H-Index: 71
view all 8 authors...
Background The pancreas remains an organ for which routine laparoscopic resection is uncommon. Study Design This is a review of all distal pancreatectomies performed between January 2003 and December 2009 at Memorial Sloan-Kettering Cancer Center. Variables were compared between laparoscopic and open groups in unmatched and matched analyses. Results During the 7-year study period, 343 distal pancreatectomies were performed; 107 (31%) were attempted laparoscopically and 236 (69%) were performed o...
131 CitationsSource
#1Hjalmar C. van Santvoort (UU: Utrecht University)H-Index: 38
#2Marc G. Besselink (Radboud University Nijmegen Medical Centre)H-Index: 50
Last. Abstr ActH-Index: 65
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Background Necrotizing pancreatitis with infected necrotic tissue is associated with a high rate of complications and death. Standard treatment is open necrosectomy. The outcome may be improved by a minimally invasive step-up approach. Methods In this multicenter study, we randomly assigned 88 patients with necrotizing pancreatitis and suspected or confirmed infected necrotic tissue to undergo primary open necrosectomy or a step-up approach to treatment. The step-up approach consisted of percuta...
689 CitationsSource
#1Shyam Varadarajulu (UAB: University of Alabama at Birmingham)H-Index: 45
#2Jessica Trevino (UAB: University of Alabama at Birmingham)H-Index: 17
Last. John D. Christein (UAB: University of Alabama at Birmingham)H-Index: 31
view all 3 authors...
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, ...
20 CitationsSource
#1Stephen R. Grobmyer (UF: University of Florida)H-Index: 36
#2Darrell Hunt (UF: University of Florida)H-Index: 3
Last. Steven N. Hochwald (UF: University of Florida)H-Index: 42
view all 6 authors...
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...
23 Citations
#1Brian K. P. Goh (SGH: Singapore General Hospital)H-Index: 31
Last. London L. P. J. OoiH-Index: 40
view all 10 authors...
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...
170 CitationsSource
#1Abraham Mathew Mbbs Mhes (PSU: Pennsylvania State University)H-Index: 15
#2Arnab Biswas (PSU: Pennsylvania State University)H-Index: 2
Last. Kevin P. Meitz (PSU: Pennsylvania State University)H-Index: 1
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Background The success of endoscopic intervention in the management of uncomplicated pancreatic pseudocysts has allowed endoscopists to be more aggressive in managing complicated pancreatic fluid collections. Surgery is considered the mainstay of therapy once pancreatic abscesses develop. As a second-line treatment, endoscopic drainage of pancreatic abscess has been performed in those who are not candidates for surgery. Objective Our purpose was to report our experience with single-session endos...
49 CitationsSource
Cited By32
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#1Andrew C. Storm (Mayo Clinic)H-Index: 5
#2Michael J. Levy (Mayo Clinic)H-Index: 79
Last. Vinay Chandrasekhara (Mayo Clinic)H-Index: 12
view all 10 authors...
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 ...
1 CitationsSource
#1Takashi Tamura (Wakayama Medical University)H-Index: 4
#2Masayuki Kitano (Wakayama Medical University)H-Index: 27
Last. Hiroki Yamaue (Wakayama Medical University)H-Index: 46
view all 6 authors...
Source
#1Lajos Szakó (PTE: University of Pécs)H-Index: 2
#2Péter Mátrai (PTE: University of Pécs)H-Index: 7
Last. Áron Vincze (PTE: University of Pécs)H-Index: 18
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Abstract Background Pancreatic pseudocyst (PP) and walled-off necrosis can be managed endoscopically, percutaneously or surgically, but with diverse efficacy. Aims & methods A comprehensive literature search was carried out from inception to December 2018, to identify articles which compared at least two of the three kinds of treatment modalities, regarding the mortality, clinical success, recurrence, complications, cost and length of hospitalisation (LOH). Results The outcomes of endoscopic (ED...
1 CitationsSource
#1Juliana Yang (Johns Hopkins University)H-Index: 6
#2Mouen A. Khashab (Johns Hopkins University)H-Index: 47
Source
#1Takashi Tamura (Wakayama Medical University)H-Index: 4
#2Masayuki Kitano (Wakayama Medical University)H-Index: 27
Last. Hirokiyamaue (Wakayama Medical University)H-Index: 44
view all 14 authors...
Background:Postoperative pancreatic collection (POPC) is a frequent complication after pancreatectomy. Although percutaneous drainage (PD) has been the treatment of choice for POPC with encapsulati...
Source
#1Ki Byung Song (UOU: University of Ulsan)H-Index: 16
#2Jaewoo Kwon (UOU: University of Ulsan)H-Index: 4
Last. Song Cheol Kim (UOU: University of Ulsan)H-Index: 26
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Background Recently, laparoscopic distal pancreatectomy (LDP) has become the standard procedure for resection of left-sided pancreatic tumors. Fluid collection (FC) at the resection margin of the pancreatic stump after LDP is a frequent radiological finding. However, there have been few treatment guidelines and the optimal management for this clinical finding is unclear. The aim of present study is to define the incidence of FC and suggest the optimal management for FC after LDP.
1 CitationsSource
#1Daniel HughesH-Index: 3
#2Ioan Hughes ('QUB': Queen's University Belfast)H-Index: 1
Last. Achal KhannaH-Index: 1
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Background A staple line leak following a sleeve gastrectomy is associated with significant morbidity and mortality. No uniform guideline or consensus exists with regard to the optimal treatment approach to managing a staple line leak.
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#1Juliana Yang (Johns Hopkins University)H-Index: 6
#2Jeremy Kaplan (CUMC: Columbia University Medical Center)H-Index: 5
Last. Mouen A. Khashab (Johns Hopkins University)H-Index: 47
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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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Background Despite technical advances in surgical resection and postoperative management of the pancreas, surgical procedures of the pancreas are associated with a high rate of complications, resulting in a relevant morbidity and mortality. Early diagnosis and management of complications associated with pancreas surgery is mandatory, favoring a multidisciplinary approach.
1 CitationsSource
#1Mohammad Al Efishat (MSK: Memorial Sloan Kettering Cancer Center)H-Index: 5
#2Marc A. Attiyeh (MSK: Memorial Sloan Kettering Cancer Center)H-Index: 9
Last. Mark A. Schattner (MSK: Memorial Sloan Kettering Cancer Center)H-Index: 26
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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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