Fluid Collection After Partial Pancreatectomy: EUS Drainage and Long-term Follow-up

Overview

Journal Endosc Ultrasound

Date 2018 Mar 31

PMID 29600794

Citations 9

Authors

Fabrice Caillol

Sebastien Godat

Olivier Turrini

Christophe Zemmour

Erwan Bories

Christian Pesenti

Jean Phillippe Ratone

Jacques Ewald

Jean Robert Delpero

Marc Giovannini

Affiliations

Soon will be listed here.

Abstract

Background And Objectives: Postoperative fluid collection due to pancreatic leak is the most frequent complication after pancreatic surgery. EUS-guided drainage of post-pancreatic surgery fluid collection is the gold standard procedure; however, data on outcomes of this procedure are limited. The primary endpoint of our study was relapse over longterm followup, and the secondary endpoint was the efficiency and safety of EUS-guided drainage of post-pancreatic surgery fluid collection.

Patients And Methods: This retrospective study was conducted at a single center from December 2008 to April 2016. Global morbidity was defined as the occurrence of an event involving additional endoscopic procedures, hospitalization, or interventional radiologic or surgical procedures. EUS-guided drainage was considered a clinical failure if surgery was required to treat a relapse after stent removal.

Results: Fortyone patients were included. The technical success rate was 100%. Drainage was considered a clinical success in 93% (39/41) of cases. Additionally, 19 (46%) complications were identified as global morbidity. The duration between surgery and EUS-guided drainage was not a significantly related factor for morbidity rate (P = 0.8); however, bleeding due to arterial injuries (splenic artery and gastroduodenal artery) from salvage drainage procedures occurred within 25 days following the initial surgery. There was no difference in survival between patients with and without complications. No relapse was reported during the followup (median: 44.75 months; range: 29.24 to 65.74 months).

Conclusion: EUSguided drainage for post-pancreatic surgery fluid collection was efficient with no relapse during longterm followup. Morbidity rate was independent of the duration between the initial surgery and EUS-guided drainage; however, bleeding risk was likely more important in cases of early drainage.

Citing Articles

Early versus delayed EUS-guided drainage for postoperative pancreatic fluid collections: a systematic review and meta-analysis.

Mukai T, Nakai Y, Hamada T, Matsubara S, Sasaki T, Ishiwatari H Surg Endosc. 2023; 38(1):47-55.

PMID: 38017158 PMC: 10776699. DOI: 10.1007/s00464-023-10568-y.

Postoperative computed tomography findings predict re-drainage cases after early drain removal in pancreaticoduodenectomy.

Nitta N, Maehira H, Ishikawa H, Iida H, Mori H, Maekawa T Langenbecks Arch Surg. 2023; 408(1):427.

PMID: 37921899 DOI: 10.1007/s00423-023-03165-z.

Endoscopic ultrasound-guided versus percutaneous drainage for the management of post-operative fluid collections after distal pancreatectomy.

Fogwe D, AbiMansour J, Truty M, Levy M, Storm A, Law R Surg Endosc. 2023; 37(9):6922-6929.

PMID: 37322361 DOI: 10.1007/s00464-023-10188-6.

Systematic review and meta-analysis of endoscopic ultrasound drainage for the management of fluid collections after pancreas surgery.

Ramouz A, Shafiei S, Ali-Hasan-Al-Saegh S, Khajeh E, Rio-Tinto R, Fakour S Surg Endosc. 2022; 36(6):3708-3720.

PMID: 35246738 PMC: 9085703. DOI: 10.1007/s00464-022-09137-6.

Endoscopic Ultrasound-Guided Drainage in the Management of Postoperative Pancreatic Fistula After Partial Pancreatectomy.

Wang L, Zhang Y, Chen B, Ding Y Turk J Gastroenterol. 2021; 32(11):979-987.

PMID: 34872899 PMC: 8975468. DOI: 10.5152/tjg.2020.20841.

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