Retrospective Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Jun 16, 2019; 11(6): 403-412
Published online Jun 16, 2019. doi: 10.4253/wjge.v11.i6.403
Clinical outcomes of endoscopic management of pancreatic fluid collections in cirrhotics vs non-cirrhotics: A comparative study
Sobia Laique, Matheus C Franco, Tyler Stevens, Amit Bhatt, John J Vargo, Prabhleen Chahal
Sobia Laique, Internal Medicine, Cleveland Clinic, Cleveland, OH 44195, United States
Matheus C Franco, Tyler Stevens, Amit Bhatt, John J Vargo, Prabhleen Chahal, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH 44195, United States
Author contributions: Laique S contributed to study design, acquisition of data, analysis and interpretation of data, drafting of the manuscript, critical revision of the manuscript for important intellectual content; Franco MC contributed to study concept and design, acquisition of data, drafting of the manuscript, critical revision of the manuscript for important intellectual content; Stevens T, Bhatt A and Vargo JJ contributed to critical revision of the manuscript for important intellectual content; Chahal P contributed to study supervision, study concept and design, critical revision of the manuscript for important intellectual content.
Institutional review board statement: The study was approved by the Cleveland Clinic Institutional Review Board.
Conflict-of-interest statement: Nothing to disclose.
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/
Corresponding author: Prabhleen Chahal, MD, Attending Doctor, Staff Physician, Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Ave, A30, Cleveland, OH 44195, United States. chahalp@ccf.org
Telephone: +1-216-4446521 Fax: +1-216-4446284
Received: March 2, 2019
Peer-review started: March 3, 2019
First decision: March 20, 2019
Revised: May 16, 2019
Accepted: May 23, 2019
Article in press: May 23, 2019
Published online: June 16, 2019
Core Tip

Core tip: Endoscopic ultrasound-guided management of pancreatic fluid collections (PFCs) using self-expandable metal stents has a high technical and clinical success rate. However, their use in cirrhotics has not yet been studied. We conducted the first comparative study to assess the safety and outcomes of endoscopic management of symptomatic PFCs in cirrhotics vs non-cirrhotics. Despite a 100% technical success rate, clinical success was achieved in only 60% of cirrhotic patients with a procedure-related adverse event rate of 60%. Moreover, fatal adverse events were statistically more common in cirrhotics compared with non-cirrhotics (0% vs 40%; P = 0.023). Thus, given the high morbidity and mortality as evidenced by our cohort, caution must be exercised in this group. Larger, multicenter studies are warranted to further characterize the risk profile and outcomes in these patients.