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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 S...

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Autores principales: Xu, Ming Ming, Andalib, Iman, Novikov, Aleksey, Dawod, Enad, Gabr, Moamen, Gaidhane, Monica, Tyberg, Amy, Kahaleh, Michel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Gastrointestinal Endoscopy 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7280836/
https://www.ncbi.nlm.nih.gov/pubmed/31794655
http://dx.doi.org/10.5946/ce.2019.113
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author Xu, Ming Ming
Andalib, Iman
Novikov, Aleksey
Dawod, Enad
Gabr, Moamen
Gaidhane, Monica
Tyberg, Amy
Kahaleh, Michel
author_facet Xu, Ming Ming
Andalib, Iman
Novikov, Aleksey
Dawod, Enad
Gabr, Moamen
Gaidhane, Monica
Tyberg, Amy
Kahaleh, Michel
author_sort Xu, Ming Ming
collection PubMed
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.
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spelling pubmed-72808362020-06-17 Endoscopic Therapy for Pancreatic Fluid Collections: A Definitive Management Using a Dedicated Algorithm Xu, Ming Ming Andalib, Iman Novikov, Aleksey Dawod, Enad Gabr, Moamen Gaidhane, Monica Tyberg, Amy Kahaleh, Michel Clin Endosc Original Article 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. Korean Society of Gastrointestinal Endoscopy 2020-05 2019-12-03 /pmc/articles/PMC7280836/ /pubmed/31794655 http://dx.doi.org/10.5946/ce.2019.113 Text en Copyright © 2020 Korean Society of Gastrointestinal Endoscopy This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Xu, Ming Ming
Andalib, Iman
Novikov, Aleksey
Dawod, Enad
Gabr, Moamen
Gaidhane, Monica
Tyberg, Amy
Kahaleh, Michel
Endoscopic Therapy for Pancreatic Fluid Collections: A Definitive Management Using a Dedicated Algorithm
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 Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7280836/
https://www.ncbi.nlm.nih.gov/pubmed/31794655
http://dx.doi.org/10.5946/ce.2019.113
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