Synapse - Endoscopic versus percutaneous drainage of post-operative peripancreatic fluid collections following pancreatic resection

Endoscopic versus percutaneous drainage of post-operative peripancreatic fluid collections following pancreatic resection Journal Article

Authors:	Al Efishat, M.; Attiyeh, M. A.; Eaton, A. A.; Gönen, M.; Covey, A. M.; D'Angelica, M. I.; DeMatteo, R. P.; Kingham, T. P.; Balachandran, V.; Jarnagin, W. R.; Gerdes, H.; Allen, P. J.; Schattner, M. A.
Article Title:	Endoscopic versus percutaneous drainage of post-operative peripancreatic fluid collections following pancreatic resection
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 each group with a median age of 62 years. For primary drainage, technical success was achieved in almost all patients in both endoscopic and percutaneous groups (100% and 97%, p = NS); clinical success was achieved in 67% and 59%, respectively (p = 0.63). At least one “salvage” drainage procedure was required in 13 endoscopic patients versus 16 in the percutaneous group. Clinical success was achieved following the first salvage. Procedure in 85% of the endoscopic patients and 88% of the percutaneous patients (p = 0.62). Stent/drain duration (59 vs 33 days, p < 0.001) and number of post-procedural CT studies (2 vs 1, p = 0.02) were significantly higher in the endoscopic group. There was no difference in length of stay, complication, or recurrence between the two groups. Conclusion: Endoscopic drainage of post-operative PFC appears to be safe and effective with comparable success rates and outcomes to percutaneous drainage. © 2018 International Hepato-Pancreato-Biliary Association Inc.
Keywords:	adult; controlled study; major clinical study; salvage therapy; adjuvant therapy; pancreas cancer; outcome assessment; antineoplastic agent; prospective study; cohort analysis; postoperative complication; length of stay; endoscopic surgery; patient safety; recurrent disease; pancreatectomy; intermethod comparison; clinical effectiveness; patient care planning; percutaneous drainage; body fluid; clinical outcome; human; male; female; article; postoperative peripancreatic fluid collection
Journal Title:	HPB
Volume:	21
Issue:	4
ISSN:	1365-182X
Publisher:	Elsevier Science, Inc.
Date Published:	2019-01-01
Start Page:	434
End Page:	443
Language:	English
DOI:	10.1016/j.hpb.2018.08.010
PUBMED:	30293867
PROVIDER:	scopus
PMCID:	PMC7570452
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85054157207&doi=10.1016%2fj.hpb.2018.08.010&partnerID=40&md5=a88fcd5da5edbbcc9920ead49c4e116e
Notes:	Article -- Export Date: 1 May 2019 -- Source: Scopus