EUS-GUIDED DRAINAGE OF PANCREATIC COLLECTIONS: A SINGLE-CENTER EXPERIENCE

Aims:

To assess the efficiency and complication rates of EUS-guided drainage of pancreatic collections in a tertiary center.

Methods:

A retrospective study of all patients who underwent EUS-guided drainage between January, 2000, and December, 2016, at our department. We evaluated their clinical data, indications, course of procedures, complications, and treatment outcomes.

Results:

Among 104 patients who underwent EUS-guided drainage, 76 (73%) were treated for a pseudocyst and 28 (27%) patients for a walled-off pancreatic necrosis. The average size of PC was 9 ± 4.8 cm. Drainage was performed transgastrically (62%), transduodenally (17%), or transpapillary (21%). Patients were treated with plastic (91%) or metal (9%) stents. The technical success rate was 93%. PC resolution occurred in 75% of cases with a median drainage duration of 64 (1 – 1,744) days. The clinical success rates of plastic and metal stents were 72% and 100%, resp. (p = 0.319). Reported complications were bleeding (4), perforation (5), and secondary infections (8). The average size of WOPN was 11 ± 5.8 cm. WOPN drainage was performed transgastrically (93%) or tranduodenally (7%). Patients were treated with plastic stents (73%), metal stents (21%), or a combination of both (8%). Technical success rate was 96%. Endoscopic necrectomy was performed on 9 patients (32%). Resolution of WOPN occurred in 77% of cases with a median drainage duration of 69 (1 – 1,210) days. Clinical success rates using plastic and metal stents were 71% and 100%, resp. (p = 0.289). Encountered complications were bleeding (1), perforation (1), and secondary infections (3).

Conclusions:

EUS-guided drainage was an effective method for the treatment of pancreatic fluid collections with a significant rate of complications. Its effectiveness was not influenced by the type of collection; the trend of better clinical success rate using metal stents did not reach statistical significance.