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DOI: 10.1055/s-0041-1724937
Is EUS-Guided Single-Step Complete-Aspiration Useful In The Management Of Abdominal Collections?
Aims Most endoscopic management of abdominal collections includes Endoscopic Ultrasound (EUS)-guided transmural drainage or transpapillary drainage via ERCP. EUS-guided single-step complete-aspiration (SSCA) is little reported and there are some doubts about its real effectiveness.
Methods Specific database review and retrospective cohort identification that includes abdominal collections treated by EUS-guided SSCA. The decision to apply this strategy was based on collection size and endoscopist criteria. Exclusion: transmural and/or transpapillary drainage. Technical success: needle access inside the collection and complete liquid aspiration liquid with total collapse. Clinical success defined as reduction ≥ 50 % of initial size or decrease <50 % with clinical improvement, in subsequent imaging control. Failure: whether increased collection or need for clinical re-intervention. Other variables: demographics, procedure techniques, collection (etiology, size, infection), re-intervention, safety.
Results Of 180 collections endoscopically treated, selection of 42 patients and including 40 (23 men, mean age 55years (SD13.6)). Exclusion of 2 cases due lack of follow-up. Collections data: mean size 55-mm (SD19.7); liquid vs solid-content, 77 vs 23 %; positive culture in 45 %; pancreatic inflammatory nature in 85 % (n-34, including 67 % pseudocyst and 41 % chronic pancreatitis). Technical success of 100 %, clinical success of 50 % with a first session and 60 % after two. Adverse events detected in 5 %: one procedure-related bleeding, and one patient with abdominal pain. The most used needle type, 19 G (87 %). Mean follow-up, 574-days (SD 442).
No identification of factors related to clinical success (Table). Subgroup analysis according to collection etiology without differences. Failed-SSCA management: 40 % conservative attitude vs 60 % re-intervention, endoscopic 66.6 % (other SSCA in 4; transmural pigtail placement in 3, and lumen-apposing stent in 1), in 25 % percutaneous and 8.3 % surgery.
Sex (Men/Female), n (%) |
11(47)/9(52) |
0.74 |
Etiology (pancreatic/non-pancreatic), n (%) |
15(44)/5(83) |
0.077 |
Microbiology (positive/negative), n (%) |
7(38)/13(68) |
0.072 |
Age, mean (SD), years Clinical success group Non-clinical success group |
56.3 (15.0) 56.5 (12.2) |
0.493 |
Collection size, mean (SD), mm Clinical success group Non-clinical success group |
56.8 (17.6) 54.6 (22.4) |
0.414 |
Conclusions In a percentage of selected abdominal collections treatment by EUS-SSCA could save a more aggressive strategy. No specific factor associated with failure of this strategy has been identified.
Citation Velasquez-Rodriguez JG, Maisterra S, Colan Hernandez J et al. eP447 IS EUS-GUIDED SINGLE-STEP COMPLETE-ASPIRATION USEFUL IN THE MANAGEMENT OF ABDOMINAL COLLECTIONS? Endoscopy 2021; 53: S244.
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Publikationsverlauf
Artikel online veröffentlicht:
19. März 2021
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