Endoscopic Therapy for Pancreatic Fluid Collections: A Definitive Management Using a Dedicated Algorithm
Background/Aims Endoscopic ultrasonography (EUS)-guided drainage is the preferred approach for infected or symptomatic pancreatic fluid collections (PFCs). Here, we developed an algorithm for the management of pancreatitis complicated by PFCs and report on its effcacy and safety. Methods Between Sep...
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| Format: | Article |
| Language: | English |
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Korean Society of Gastrointestinal Endoscopy
2020-05-01
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| Series: | Clinical Endoscopy |
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| Online Access: | http://www.e-ce.org/upload/pdf/ce-2019-113.pdf |
| _version_ | 1797668573114531840 |
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| author | Ming Ming Xu Iman Andalib Aleksey Novikov Enad Dawod Moamen Gabr Monica Gaidhane Amy Tyberg Michel Kahaleh |
| author_facet | Ming Ming Xu Iman Andalib Aleksey Novikov Enad Dawod Moamen Gabr Monica Gaidhane Amy Tyberg Michel Kahaleh |
| author_sort | Ming Ming Xu |
| collection | DOAJ |
| description | Background/Aims Endoscopic ultrasonography (EUS)-guided drainage is the preferred approach for infected or symptomatic pancreatic fluid collections (PFCs). Here, we developed an algorithm for the management of pancreatitis complicated by PFCs and report on its effcacy and safety. Methods Between September 2011 and October 2017, patients were prospectively managed according to the algorithm. PFCs were classified as poorly organized fluid collections (POFCs), pancreatic pseudocysts (PPs), or walled-off pancreatic necrosis (WOPN). Clinical success was defined as a decrease in PFC size by ≥50% of the maximal diameter or to ≤2 cm. Results A total of 108 patients (62% male; mean age, 53 years) were included: 13 had POFCs, 43 had PPs, and 52 had WOPN. Seventytwo patients (66%) required a pancreatic duct (PD) stent, whereas 65 (60%) received enteral feeding. A total of 103 (95%) patients achieved clinical success. Eight patients experienced complications including bleeding (n=6) and surgical intervention (n=2). Patients with enteral feeding were 3.4 times more likely to achieve resolution within 60 days (p=0.0421), whereas those with PD stenting was five times more likely to achieve resolution within 90 days (p=0.0069). Conclusions A high PFC resolution rate can be achieved when a dedicated algorithm encompassing EUS-guided drainage, PD stenting, and early enteral feeding is adopted. |
| first_indexed | 2024-03-11T20:31:20Z |
| format | Article |
| id | doaj.art-741168fd6d024702bffdc146e055ef12 |
| institution | Directory Open Access Journal |
| issn | 2234-2400 2234-2443 |
| language | English |
| last_indexed | 2024-03-11T20:31:20Z |
| publishDate | 2020-05-01 |
| publisher | Korean Society of Gastrointestinal Endoscopy |
| record_format | Article |
| series | Clinical Endoscopy |
| spelling | doaj.art-741168fd6d024702bffdc146e055ef122023-10-02T08:28:27ZengKorean Society of Gastrointestinal EndoscopyClinical Endoscopy2234-24002234-24432020-05-0153335536010.5946/ce.2019.1137305Endoscopic Therapy for Pancreatic Fluid Collections: A Definitive Management Using a Dedicated AlgorithmMing Ming Xu0Iman Andalib1Aleksey Novikov2Enad Dawod3Moamen Gabr4Monica Gaidhane5Amy Tyberg6Michel Kahaleh7 Division of Gastroenterology, Southern California Permanente Medical Group, Los Angeles, CA, USA Division of Gastroenterology, Rutgers University, Robert Wood Johnson Medical School, New Brunswick, NJ, USA Division of Gastroenterology, Thomas Jefferson University Hospital, Philadelphia, PA, USA Division of Gastroenterology, Weill Cornell Medical College, New York, NY, USA Division of Gastroenterology, Weill Cornell Medical College, New York, NY, USA Division of Gastroenterology, Rutgers University, Robert Wood Johnson Medical School, New Brunswick, NJ, USA Division of Gastroenterology, Rutgers University, Robert Wood Johnson Medical School, New Brunswick, NJ, USA Division of Gastroenterology, Rutgers University, Robert Wood Johnson Medical School, New Brunswick, NJ, USABackground/Aims Endoscopic ultrasonography (EUS)-guided drainage is the preferred approach for infected or symptomatic pancreatic fluid collections (PFCs). Here, we developed an algorithm for the management of pancreatitis complicated by PFCs and report on its effcacy and safety. Methods Between September 2011 and October 2017, patients were prospectively managed according to the algorithm. PFCs were classified as poorly organized fluid collections (POFCs), pancreatic pseudocysts (PPs), or walled-off pancreatic necrosis (WOPN). Clinical success was defined as a decrease in PFC size by ≥50% of the maximal diameter or to ≤2 cm. Results A total of 108 patients (62% male; mean age, 53 years) were included: 13 had POFCs, 43 had PPs, and 52 had WOPN. Seventytwo patients (66%) required a pancreatic duct (PD) stent, whereas 65 (60%) received enteral feeding. A total of 103 (95%) patients achieved clinical success. Eight patients experienced complications including bleeding (n=6) and surgical intervention (n=2). Patients with enteral feeding were 3.4 times more likely to achieve resolution within 60 days (p=0.0421), whereas those with PD stenting was five times more likely to achieve resolution within 90 days (p=0.0069). Conclusions A high PFC resolution rate can be achieved when a dedicated algorithm encompassing EUS-guided drainage, PD stenting, and early enteral feeding is adopted.http://www.e-ce.org/upload/pdf/ce-2019-113.pdfendoscopic ultrasonographyenteral feedingpancreatic pseudocystpancreatitisstents |
| spellingShingle | Ming Ming Xu Iman Andalib Aleksey Novikov Enad Dawod Moamen Gabr Monica Gaidhane Amy Tyberg Michel Kahaleh Endoscopic Therapy for Pancreatic Fluid Collections: A Definitive Management Using a Dedicated Algorithm Clinical Endoscopy endoscopic ultrasonography enteral feeding pancreatic pseudocyst pancreatitis stents |
| title | Endoscopic Therapy for Pancreatic Fluid Collections: A Definitive Management Using a Dedicated Algorithm |
| title_full | Endoscopic Therapy for Pancreatic Fluid Collections: A Definitive Management Using a Dedicated Algorithm |
| title_fullStr | Endoscopic Therapy for Pancreatic Fluid Collections: A Definitive Management Using a Dedicated Algorithm |
| title_full_unstemmed | Endoscopic Therapy for Pancreatic Fluid Collections: A Definitive Management Using a Dedicated Algorithm |
| title_short | Endoscopic Therapy for Pancreatic Fluid Collections: A Definitive Management Using a Dedicated Algorithm |
| title_sort | endoscopic therapy for pancreatic fluid collections a definitive management using a dedicated algorithm |
| topic | endoscopic ultrasonography enteral feeding pancreatic pseudocyst pancreatitis stents |
| url | http://www.e-ce.org/upload/pdf/ce-2019-113.pdf |
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