Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Sep 16, 2017; 9(9): 486-493
Published online Sep 16, 2017. doi: 10.4253/wjge.v9.i9.486
Novel and supplementary management of pancreatic fluid collections: Endoscopic ultrasound-guided drainage
Si-Jie Hao, Wei-Jia Xu, Yang Di, Lie Yao, Hang He, Feng Yang, Chen Jin, Liang Zhong, De-Liang Fu
Si-Jie Hao, Yang Di, Lie Yao, Hang He, Feng Yang, Chen Jin, De-Liang Fu, Department of Pancreatic surgery, Huashan Hospital, Fudan University, Shanghai 200040, China
Wei-Jia Xu, Liang Zhong, Department of Gastroenterology and Digestive Endoscopy, Huashan Hospital, Fudan University, Shanghai 200040, China
Author contributions: Hao SJ and Xu WJ contributed equally to the work; Hao SJ designed and performed the research; Hao SJ and Xu WJ wrote the paper; Di Y, Jin C and Zhong L performed the EUS process; Yao L, Yang F and Fu DL performed the surgical management; Yao L, He H and Yang F provided clinical data collection; Xu WJ performed statistics analysis; Jin C and Zhong L supervised the report.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Huashan Hospital, Fudan University.
Informed consent statement: Patients were required to give informed consent to the study and the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Chen Jin, MD, PhD, Professor, Department of Pancreatic Surgery, Huashan Hospital, Fudan University, No.12 Urumuqi Zhong Road, Shanghai 200040, China. Jinchen@huashan.org.cn
Telephone: +86-21-52887160 Fax: +86-21-52888277
Received: January 27, 2017
Peer-review started: February 12, 2017
First decision: March 31, 2017
Revised: July 31, 2017
Accepted: August 3, 2017
Article in press: August 4, 2017
Published online: September 16, 2017
Abstract
AIM

To compare efficacy and safety of endoscopic ultrasound (EUS)-guided and surgical drainage in pancreatic fluid collection management.

METHODS

Data were obtained retrospectively from January 2012 to December 2016. Patients with pancreatic fluid collection were performed EUS-guided or surgical procedure. Main outcome measures including clinical efficiency, complication, duration of procedures, hospital stay and cost were analyzed.

RESULTS

Thirty-six patients were enrolled into the study, including 14 in endoscopic group while 22 in the surgical group. Twelve (86%) patients were treated successfully by endoscopic approach while 21 (95%) patients benefited through surgical procedure. Endoscopic treatment had higher recurrence and complication rates than surgery, resulting in more re-interventions. Meanwhile, duration of procedure, hospital stay and cost were significantly lower in endoscopic group.

CONCLUSION

Both approaches were effective and safe. EUS-guided approach should be the first-line treatment in mild and simple cases, while surgical approach should be considered as priority in severe and complex cases.

Keywords: Endoscopic ultrasound-guided drainage, Pancreatic fluid collection, Post-operative pancreatic leakage, Cyst-gastrostomy

Core tip: This retrospective study was to compare efficacy and safety of endoscopic ultrasound (EUS)-guided and surgical drainage in pancreatic fluid collection management after acute pancreatitis or pancreatic surgery. Of all the 36 patients, 14 patients were performed EUS-guided drainage while 22 patients were performed surgical procedure. Endoscopic treatment had higher recurrence and complication rates than surgery, resulting in more re-interventions. Meanwhile, duration of procedure, hospital stay and cost were significantly lower in endoscopic group. Both approaches were effective and safe. EUS-guided approach should be the first-line treatment in mild and simple cases, while surgical approach should be considered as priority in severe and complex cases.