Impact of endoscopic ultrasound‐guided transmural drainage for postoperative pancreatic fistula after pancreatic surgery

Abstract Objectives Postoperative pancreatic fistula (POPF) is a major cause of morbidity after pancreatic surgery. Recently, endoscopic ultrasound‐guided transmural drainage (EUS‐TD) has been widely used to manage pancreatic pseudocysts after acute pancreatitis. Several studies have reported the ef...

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Main Authors: Ryoichi Miyamoto, Amane Takahashi, Toshiro Ogura, Kei Kitamura, Hiroyuki Ishida, Shinichi Matsudaira, Yuko Suzuki, Satoshi Shimizu, Yoshiyuki Kawashima
Format: Article
Language:English
Published: Wiley 2024-04-01
Series:DEN Open
Subjects:
Online Access:https://doi.org/10.1002/deo2.270
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author Ryoichi Miyamoto
Amane Takahashi
Toshiro Ogura
Kei Kitamura
Hiroyuki Ishida
Shinichi Matsudaira
Yuko Suzuki
Satoshi Shimizu
Yoshiyuki Kawashima
author_facet Ryoichi Miyamoto
Amane Takahashi
Toshiro Ogura
Kei Kitamura
Hiroyuki Ishida
Shinichi Matsudaira
Yuko Suzuki
Satoshi Shimizu
Yoshiyuki Kawashima
author_sort Ryoichi Miyamoto
collection DOAJ
description Abstract Objectives Postoperative pancreatic fistula (POPF) is a major cause of morbidity after pancreatic surgery. Recently, endoscopic ultrasound‐guided transmural drainage (EUS‐TD) has been widely used to manage pancreatic pseudocysts after acute pancreatitis. Several studies have reported the effectiveness of EUS‐TD for POPF, although there is insufficient evidence regarding the performance of EUS‐TD for POPF. We herein report on the safety, efficacy, and appropriate timing of EUS‐TD for POPF compared with conventional percutaneous intervention. Methods Eight patients who underwent EUS‐TD of POPF and 36 patients who underwent percutaneous intervention were retrospectively enrolled. Clinical outcomes, including technical success, clinical success, and complications, were analyzed among the two groups. Results In terms of clinical outcomes between the EUS‐TD and percutaneous intervention groups, significant differences were observed in the number of interventions (1 vs. 4, p = 0.011), period of clinical success (6 days vs. 11 days, p = 0.001), incidence of complications (0 vs. 3, p = 0.021), postoperative hospital stays (27 days vs. 34 days, p = 0.027), and recurrence of POPF (0 vs. 5, p = 0.001). Conclusions EUS‐TD for POPF appears to be safe and technically feasible. This approach should be considered a therapeutic option in patients with POPF after pancreatic surgery.
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spelling doaj-art-78787e687f8d44a79e68b774eabc68842025-08-20T03:38:54ZengWileyDEN Open2692-46092024-04-0141n/an/a10.1002/deo2.270Impact of endoscopic ultrasound‐guided transmural drainage for postoperative pancreatic fistula after pancreatic surgeryRyoichi Miyamoto0Amane Takahashi1Toshiro Ogura2Kei Kitamura3Hiroyuki Ishida4Shinichi Matsudaira5Yuko Suzuki6Satoshi Shimizu7Yoshiyuki Kawashima8Department of Gastroenterological Surgery Saitama Cancer Center SaitamaJapanDepartment of Gastroenterological Surgery Saitama Cancer Center SaitamaJapanDepartment of Gastroenterological Surgery Saitama Cancer Center SaitamaJapanDepartment of Gastroenterological Surgery Saitama Cancer Center SaitamaJapanDepartment of Gastroenterological Surgery Saitama Cancer Center SaitamaJapanDepartment of Gastroenterological Surgery Saitama Cancer Center SaitamaJapanDepartment of Gastroenterology Saitama Cancer Center SaitamaJapanDepartment of Gastroenterology Saitama Cancer Center SaitamaJapanDepartment of Gastroenterological Surgery Saitama Cancer Center SaitamaJapanAbstract Objectives Postoperative pancreatic fistula (POPF) is a major cause of morbidity after pancreatic surgery. Recently, endoscopic ultrasound‐guided transmural drainage (EUS‐TD) has been widely used to manage pancreatic pseudocysts after acute pancreatitis. Several studies have reported the effectiveness of EUS‐TD for POPF, although there is insufficient evidence regarding the performance of EUS‐TD for POPF. We herein report on the safety, efficacy, and appropriate timing of EUS‐TD for POPF compared with conventional percutaneous intervention. Methods Eight patients who underwent EUS‐TD of POPF and 36 patients who underwent percutaneous intervention were retrospectively enrolled. Clinical outcomes, including technical success, clinical success, and complications, were analyzed among the two groups. Results In terms of clinical outcomes between the EUS‐TD and percutaneous intervention groups, significant differences were observed in the number of interventions (1 vs. 4, p = 0.011), period of clinical success (6 days vs. 11 days, p = 0.001), incidence of complications (0 vs. 3, p = 0.021), postoperative hospital stays (27 days vs. 34 days, p = 0.027), and recurrence of POPF (0 vs. 5, p = 0.001). Conclusions EUS‐TD for POPF appears to be safe and technically feasible. This approach should be considered a therapeutic option in patients with POPF after pancreatic surgery.https://doi.org/10.1002/deo2.270EUS‐guided drainagepancreatic fistulapancreatic fluid collectionspancreatic surgeryPOPF
spellingShingle Ryoichi Miyamoto
Amane Takahashi
Toshiro Ogura
Kei Kitamura
Hiroyuki Ishida
Shinichi Matsudaira
Yuko Suzuki
Satoshi Shimizu
Yoshiyuki Kawashima
Impact of endoscopic ultrasound‐guided transmural drainage for postoperative pancreatic fistula after pancreatic surgery
DEN Open
EUS‐guided drainage
pancreatic fistula
pancreatic fluid collections
pancreatic surgery
POPF
title Impact of endoscopic ultrasound‐guided transmural drainage for postoperative pancreatic fistula after pancreatic surgery
title_full Impact of endoscopic ultrasound‐guided transmural drainage for postoperative pancreatic fistula after pancreatic surgery
title_fullStr Impact of endoscopic ultrasound‐guided transmural drainage for postoperative pancreatic fistula after pancreatic surgery
title_full_unstemmed Impact of endoscopic ultrasound‐guided transmural drainage for postoperative pancreatic fistula after pancreatic surgery
title_short Impact of endoscopic ultrasound‐guided transmural drainage for postoperative pancreatic fistula after pancreatic surgery
title_sort impact of endoscopic ultrasound guided transmural drainage for postoperative pancreatic fistula after pancreatic surgery
topic EUS‐guided drainage
pancreatic fistula
pancreatic fluid collections
pancreatic surgery
POPF
url https://doi.org/10.1002/deo2.270
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