Display options
Cite
Xu MM, Andalib I, Novikov A, et al. Endoscopic Therapy for Pancreatic Fluid Collections: A Definitive Management Using a Dedicated Algorithm. Clin Endosc. 2019;53(3):355-360doi: 10.5946/ce.2019.113.
Xu, M. M., Andalib, I., Novikov, A., Dawod, E., Gabr, M., Gaidhane, M., Tyberg, A., & Kahaleh, M. (2020). Endoscopic Therapy for Pancreatic Fluid Collections: A Definitive Management Using a Dedicated Algorithm. Clinical endoscopy, 53(3), 355-360. https://doi.org/10.5946/ce.2019.113
Xu, Ming Ming, et al. "Endoscopic Therapy for Pancreatic Fluid Collections: A Definitive Management Using a Dedicated Algorithm." Clinical endoscopy vol. 53,3 (2020): 355-360. doi: https://doi.org/10.5946/ce.2019.113
Xu MM, Andalib I, Novikov A, Dawod E, Gabr M, Gaidhane M, Tyberg A, Kahaleh M. Endoscopic Therapy for Pancreatic Fluid Collections: A Definitive Management Using a Dedicated Algorithm. Clin Endosc. 2020 May;53(3):355-360. doi: 10.5946/ce.2019.113. Epub 2019 Dec 03. PMID: 31794655; PMCID: PMC7280836.
Copy Download .nbib Format: NLM
Share it on

Clin Endosc. 2020 May;53(3):355-360. doi: 10.5946/ce.2019.113. Epub 2019 Dec 03.

Endoscopic Therapy for Pancreatic Fluid Collections: A Definitive Management Using a Dedicated Algorithm.

Clinical endoscopy

Ming Ming Xu, Iman Andalib, Aleksey Novikov, Enad Dawod, Moamen Gabr, Monica Gaidhane, Amy Tyberg, Michel Kahaleh

Affiliations

  1. Division of Gastroenterology, Southern California Permanente Medical Group, Los Angeles, CA, USA.
  2. Division of Gastroenterology, Rutgers University, Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
  3. Division of Gastroenterology, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
  4. Division of Gastroenterology, Weill Cornell Medical College, New York, NY, USA.

PMID: 31794655 PMCID: PMC7280836 DOI: 10.5946/ce.2019.113

Abstract

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).

CONCLUSION:  A high PFC resolution rate can be achieved when a dedicated algorithm encompassing EUS-guided drainage, PD stenting, and early enteral feeding is adopted.

Keywords: Endoscopic ultrasonography; Enteral feeding; Pancreatic pseudocyst; Pancreatitis; Stents

References

  1. Pancreas. 2008 Mar;36(2):105-12 - PubMed
  2. Endoscopy. 2015 Jan;47(1):63-7 - PubMed
  3. J Hepatobiliary Pancreat Sci. 2015 Jan;22(1):20-6 - PubMed
  4. Surg Clin North Am. 2007 Dec;87(6):1447-60, ix - PubMed
  5. Gastroenterology. 2013 Sep;145(3):583-90.e1 - PubMed
  6. Gastrointest Endosc. 2016 Mar;83(3):481-8 - PubMed
  7. Clin Endosc. 2014 Sep;47(5):429-31 - PubMed
  8. Gastrointest Endosc. 2005 Jul;62(1):92-100 - PubMed
  9. Am J Gastroenterol. 2006 Oct;101(10):2347-55 - PubMed
  10. Endoscopy. 2009 Oct;41(10):842-8 - PubMed
  11. Gastrointest Endosc. 2008 Dec;68(6):1102-11 - PubMed
  12. Surg Laparosc Endosc Percutan Tech. 2013 Jun;23(3):330-3 - PubMed
  13. J Gastroenterol Hepatol. 2010 Mar;25(3):526-31 - PubMed
  14. Gastrointest Endosc Clin N Am. 2013 Oct;23(4):787-802 - PubMed
  15. Br J Surg. 1993 Jan;80(1):94-9 - PubMed
  16. Gastroenterology. 2011 Oct;141(4):1254-63 - PubMed
  17. Endoscopy. 2006 Apr;38(4):355-9 - PubMed
  18. J Gastrointest Surg. 2011 Nov;15(11):2080-8 - PubMed
  19. J Am Coll Surg. 2009 May;208(5):790-9; discussion 799-801 - PubMed
  20. Dig Endosc. 2015 May;27(4):486-498 - PubMed
  21. Gastroenterology. 1996 Sep;111(3):755-64 - PubMed
  22. Gastrointest Endosc. 2006 May;63(6):797-803 - PubMed
  23. PLoS One. 2013 Jun 06;8(6):e64926 - PubMed
  24. Ann Gastroenterol. 2014;27(3):258-261 - PubMed
  25. Crit Care. 2013 Jun 20;17(3):R118 - PubMed
  26. Gastroenterol Clin North Am. 2016 Mar;45(1):9-27 - PubMed
  27. Surgery. 2004 Oct;136(4):909-16 - PubMed
  28. HPB (Oxford). 2006;8(6):432-41 - PubMed
  29. Gastrointest Endosc. 2012 Sep;76(3):679-84 - PubMed
  30. Cochrane Database Syst Rev. 2010 Jan 20;(1):CD002837 - PubMed
  31. Gut. 2009 Sep;58(9):1260-6 - PubMed
  32. Gastrointest Endosc. 2015 Apr;81(4):804-12 - PubMed
  33. Ann Surg. 1985 Dec;202(6):720-4 - PubMed
  34. World J Gastroenterol. 2016 Feb 21;22(7):2256-70 - PubMed
  35. Am J Surg. 2001 May;181(5):411-5 - PubMed

Publication Types