Published online Jun 16, 2019. doi: 10.4253/wjge.v11.i6.403
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: 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.