Retrospective cohort study comparing endoscopic ultrasound‐guided and percutaneous drainage of upper abdominal abscesses

Autor:	Carlos de la Serna-Higuera, Marta Cimavilla, Raúl Torres Yuste, Gabriel Carlos Fernández Pérez, Manuel Perez-Miranda, Ana Yaiza Carbajo, Francisco Brunie Vegas, Paula Gil-Simon, Francisco Javier García-Alonso
Rok vydání:	2019
Předmět:	Male Endoscopic ultrasound medicine.medical_specialty Abdominal Abscess Percutaneous Endosonography 03 medical and health sciences 0302 clinical medicine medicine Humans Radiology Nuclear Medicine and imaging Adverse effect Ultrasonography Interventional Aged Retrospective Studies medicine.diagnostic_test business.industry Standard treatment Gastroenterology Retrospective cohort study Middle Aged medicine.disease digestive system diseases Surgery 030220 oncology & carcinogenesis Etiology Drainage Female 030211 gastroenterology & hepatology business Liver abscess
Zdroj:	Digestive Endoscopy. 31:431-438
ISSN:	1443-1661 0915-5635
DOI:	10.1111/den.13342
Popis:	Background and aim Endoscopic ultrasonography (EUS)-guided drainage (EUS-D) has become the standard treatment for peripancreatic fluid collections. Its use in other intra-abdominal abscesses has been reported, although there is limited evidence. Methods We carried out a single-center retrospective cohort study comparing percutaneous drainage (PCD) and EUS-D of upper abdominal abscesses between January 2012 and June 2017. Pancreatic fluid collections and liver transplant recipients were excluded. Primary endpoints were technical and clinical success rates. Results We included 18 EUS-D (nine hepatic and nine intraperitoneal abscesses) and 62 PCD. There were no differences regarding age, gender and etiology. Size was larger in the PCD group (80 vs 65.5 mm, P = 0.04) and perivesicular location was more frequent in the PCD group (24.2% vs 11.1%, P = 0.003). In the EUS-D group, metal stents were deployed in 16 (88.9%) subjects (eight lumen-apposing metal stents and eight self-expandable metal stents), coaxial double-pigtail plastic stents in six (33.3%) and lavage/debridement was carried out in five (27.8%). There were no significant differences in technical success (EUS-D: 88.9%, PCD: 96.8%, P = 0.22) or clinical success (EUS-D: 88.9%, PCD: 82.3%, P = 0.50), with no relapses in the EUS-D group and 10 (16.1%) in the PCD group (P = 0.11). There were four (22.2%) adverse events in the EUS-D group, none of them severe, and 13 (21%) in the PCD group (P = 0.91). Conclusions EUS-D is an alternative to PCD in the treatment of upper abdominal abscesses, reaching similar success, relapse and adverse events rates.
Databáze:	OpenAIRE
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