Walled-off Peripancreatic Fluid Collections in Asian Population: Paradigm Shift from Surgical and Percutaneous to Endoscopic Drainage
| Autor: | Patpong Navicharern, Peerapol Wangrattanapranee, Rungsun Rerknimitr, Pradermchai Kongkam, Pinit Kullavanijaya, Krit Kitisin, Nonthikorn Theerasuwipakorn, Phontep Angsuwatcharakon, Wiriyaporn Ridtitid, Abbas Ali Tasneem |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Nephrology
Endoscopic ultrasound medicine.medical_specialty walled-off necrosis Percutaneous endoscopic retrograde cholangiopancreatography Pancreatic pseudocyst pseudocyst pancreatitis peripancreatic fluid collection 03 medical and health sciences 0302 clinical medicine Pancreatic tumor Internal medicine Internal Medicine Medicine Endoscopic retrograde cholangiopancreatography medicine.diagnostic_test business.industry medicine.disease Surgery pancreatic necrosis natural history 030220 oncology & carcinogenesis endoscopic ultrasound Etiology Pancreatitis 030211 gastroenterology & hepatology Original Article pseudocyst drainage business EUS-guided pseudocyst drainage pancreatic necrosectomy |
| Zdroj: | Journal of Translational Internal Medicine |
| ISSN: | 2224-4018 2450-131X |
| Popis: | Background and Objectives Drainage of symptomatic walled-off peripancreatic fluid collections (WPFCs) can be achieved by endoscopic, percutaneous, and surgical techniques. The aim of this study was to determine the current trends in management of WPFCs and the outcome of such modalities in Asian population. Methods In this retrospective analysis, all patients diagnosed with pancreatitis from 2013 to 2016 in King Chulalongkorn Memorial Hospital, Bangkok, Thailand, were analyzed. Relevant clinical data of all patients with peripancreatic fluid collections (PFCs) was reviewed. Clinical success was defined as improvement in symptoms after drainage. Results Of the total 636 patients with pancreatitis, 72 (11.3%) had WPFCs, of which 55 (8.6%) and 17 (2.7%) had pancreatic pseudocyst (PP) and walled-off necrosis (WON), respectively. The commonest etiologies of WPFCs were alcohol (38.9%) and biliary stone (29.2%). Post-procedure and pancreatic tumor related pancreatitis was found in 8.3% and 6.9% patients, respectively. PP was more common in chronic (27.8%) than acute (5.5%) pancreatitis. Of the 72 patients with WPFCs, 31 (43.1%) had local complications. Supportive, endoscopic, percutaneous, and surgical drainage were employed in 58.3%, 27.8%, 8.3%, and 5.6% with success rates being 100%, 100%, 50%, and 100%, respectively. Complications that developed after percutaneous drainage included bleeding at procedure site (n = 1), infection of PFC (n = 1), and pancreatic duct leakage (n = 1). Conclusion Over the past few years, endoscopic drainage has become the most common route of drainage of WPFCs followed by percutaneous and surgical routes. The success rate of endoscopic route is better than percutaneous and comparable to surgical modality. |
| Databáze: | OpenAIRE |
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