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HPB (Oxford). 2018 Oct 4. pii: S1365-182X(18)33940-6. doi: 10.1016/j.hpb.2018.08.010. [Epub ahead of print]

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

Author information

1
Department of Surgery, Hepatopancreaticobiliary Service, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.
2
Department of Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.
3
Department of Radiology, Interventional Radiology Service, Memorial Sloan-Kettering Cancer Center, New York, NY, 10065, USA.
4
Department of Medicine, Gastroenterology and Nutrition Service, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.
5
Department of Medicine, Gastroenterology and Nutrition Service, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA. Electronic address: schattnm@mskcc.org.

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.

PMID:
30293867
DOI:
10.1016/j.hpb.2018.08.010

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