EUS-guided drainage in the management of postoperative pancreatic leaks and fistulas (with video).


Journal

Gastrointestinal endoscopy
ISSN: 1097-6779
Titre abrégé: Gastrointest Endosc
Pays: United States
ID NLM: 0010505

Informations de publication

Date de publication:
02 2019
Historique:
received: 09 06 2018
accepted: 22 08 2018
pubmed: 5 9 2018
medline: 22 5 2019
entrez: 5 9 2018
Statut: ppublish

Résumé

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. 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 analysis. Analysis was stratified by the presence or absence of a PFC because these patients differed in treatment pathway and the presence of systemic inflammation with a median C-reactive protein of 30.7 mg/dL in patients without a PFC versus 131.0 mg/dL in patients with a PFC (P = 3.4 × 10 In this retrospective analysis, EUS-guided drainage of POPF led to a more rapid resolution. EUS may be considered as a viable option in the management of PFCs and POPF and should be evaluated in prospective studies.

Sections du résumé

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 analysis.
RESULTS
Analysis was stratified by the presence or absence of a PFC because these patients differed in treatment pathway and the presence of systemic inflammation with a median C-reactive protein of 30.7 mg/dL in patients without a PFC versus 131.0 mg/dL in patients with a PFC (P = 3.4 × 10
CONCLUSIONS
In this retrospective analysis, EUS-guided drainage of POPF led to a more rapid resolution. EUS may be considered as a viable option in the management of PFCs and POPF and should be evaluated in prospective studies.

Identifiants

pubmed: 30179609
pii: S0016-5107(18)33005-0
doi: 10.1016/j.gie.2018.08.046
pii:
doi:

Types de publication

Journal Article Video-Audio Media

Langues

eng

Sous-ensembles de citation

IM

Pagination

311-319.e1

Commentaires et corrections

Type : CommentIn
Type : CommentIn
Type : CommentIn

Informations de copyright

Copyright © 2019 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Auteurs

Christian Jürgensen (C)

Department of Hepatology and Gastroenterology, Charité University Medicine, Berlin, Germany.

Marius Distler (M)

Department of Visceral, Thoracic and Vascular Surgery, University Hospital Dresden, Technische Universität Dresden (TU Dresden), Dresden, Germany.

Alexander Arlt (A)

Department of Internal Medicine I, University Hospital Schleswig-Holstein, Kiel Campus, Kiel, Germany.

Stefan Brückner (S)

Medical Department 1, University Hospital Dresden, Technische Universität Dresden (TU Dresden), Dresden, Germany.

Mark Ellrichmann (M)

Department of Internal Medicine I, University Hospital Schleswig-Holstein, Kiel Campus, Kiel, Germany.

Katja Matthes (K)

Medical Department 1, University Hospital Dresden, Technische Universität Dresden (TU Dresden), Dresden, Germany.

Marleen Ludwig (M)

Department of General, Visceral, Thoracic, Transplantation and Pediatric Surgery, University Hospital Schleswig-Holstein, Kiel Campus, Kiel, Germany.

Stephan Sulk (S)

Medical Department 1, University Hospital Dresden, Technische Universität Dresden (TU Dresden), Dresden, Germany.

Laura Romberg (L)

Medical Department 1, University Hospital Dresden, Technische Universität Dresden (TU Dresden), Dresden, Germany.

Sebastian Zeissig (S)

Medical Department 1, University Hospital Dresden, Technische Universität Dresden (TU Dresden), Dresden, Germany.

Clemens Schafmayer (C)

Department of General, Visceral, Thoracic, Transplantation and Pediatric Surgery, University Hospital Schleswig-Holstein, Kiel Campus, Kiel, Germany.

Sebastian Hinz (S)

Department of General, Visceral, Thoracic, Transplantation and Pediatric Surgery, University Hospital Schleswig-Holstein, Kiel Campus, Kiel, Germany.

Thilo Welsch (T)

Department of Visceral, Thoracic and Vascular Surgery, University Hospital Dresden, Technische Universität Dresden (TU Dresden), Dresden, Germany.

Marcus Bahra (M)

Department of General, Visceral, Vascular and Thoracic Surgery, Charité University Medicine, Berlin, Germany.

Heiko Aselmann (H)

Department of General, Visceral, Thoracic, Transplantation and Pediatric Surgery, University Hospital Schleswig-Holstein, Kiel Campus, Kiel, Germany.

Jürgen Weitz (J)

Department of Visceral, Thoracic and Vascular Surgery, University Hospital Dresden, Technische Universität Dresden (TU Dresden), Dresden, Germany.

Fritz Klein (F)

Department of General, Visceral, Vascular and Thoracic Surgery, Charité University Medicine, Berlin, Germany.

Thomas Becker (T)

Department of General, Visceral, Thoracic, Transplantation and Pediatric Surgery, University Hospital Schleswig-Holstein, Kiel Campus, Kiel, Germany.

Jochen Hampe (J)

Medical Department 1, University Hospital Dresden, Technische Universität Dresden (TU Dresden), Dresden, Germany.

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