Detailed Abstract
[E-poster]
[EP092] Drainage procedures for post-operative pancreatic fluid collection after PD and PPPD: a comparison of EUS guided and percutaneous drainage group characteristics and outcomes
Da Hee WOO*, Jae Hoon LEE, Song Cheol KIM, Young Joo LEE, Dae Wook HWANG, Ki Byung SONG, Sang Hyun SHIN, Jae Woo KWON, Ye Jong PARK
Division of Hepato-Biliary and Pancreatic Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Korea
Introduction : POPF is a common complication of pancreas resection with no clear management guidelines. This study aims to analyze patient and fluid collection characteristics and outcomes of EUS guided and percutaneous interventions in patients with POPF after receiving PD and PPPD.
Methods : Among patients who underwent PD and PPPD between January 1, 2015 and June 30, 2019 at our center, 53 (EUS guided=32, percutaneous=21) underwent post-operative drainage procedures. Demographic data, symptoms, lab data, fluid culture results, antibiotics regimen and outcomes of these patients were analyzed.
Results : Prior to drainage, 83% had leukocytosis and 92% presented with one or more of the following symptoms: fever (70%), abdominal pain (79%), and nausea/vomiting (17%). Fluid collection diameters in axial CT imaging ranged from 33mm to 191mm with a mean of 95mm, of which 77% showed a diameter decrease of more than 50% within 8 weeks of drainage (EUS=88% vs. PCD=62%, p=0.054). 82% of fluid collections showed positive culture results and IV antibiotics were used for an average of 7.6±4.1 and 11.7±7.0 consecutive days for EUS group and PCD group respectively (p=0.021). EUS group had a shorter post procedural hospital stay than the PCD group (9.8 vs. 15.8 days, p=0.004) with no differences in technical success rates (p=1.000), reintervention rates (p=0.118), and adverse event rates between the two groups.
Conclusions : EUS guided and percutaneous drainage are equally safe and effective for managing both symptomatic and incidentally found POPF in CT imaging. However, EUS guided drainage group was associated with shorter IV antibiotics regimen and shorter hospital stay.
Methods : Among patients who underwent PD and PPPD between January 1, 2015 and June 30, 2019 at our center, 53 (EUS guided=32, percutaneous=21) underwent post-operative drainage procedures. Demographic data, symptoms, lab data, fluid culture results, antibiotics regimen and outcomes of these patients were analyzed.
Results : Prior to drainage, 83% had leukocytosis and 92% presented with one or more of the following symptoms: fever (70%), abdominal pain (79%), and nausea/vomiting (17%). Fluid collection diameters in axial CT imaging ranged from 33mm to 191mm with a mean of 95mm, of which 77% showed a diameter decrease of more than 50% within 8 weeks of drainage (EUS=88% vs. PCD=62%, p=0.054). 82% of fluid collections showed positive culture results and IV antibiotics were used for an average of 7.6±4.1 and 11.7±7.0 consecutive days for EUS group and PCD group respectively (p=0.021). EUS group had a shorter post procedural hospital stay than the PCD group (9.8 vs. 15.8 days, p=0.004) with no differences in technical success rates (p=1.000), reintervention rates (p=0.118), and adverse event rates between the two groups.
Conclusions : EUS guided and percutaneous drainage are equally safe and effective for managing both symptomatic and incidentally found POPF in CT imaging. However, EUS guided drainage group was associated with shorter IV antibiotics regimen and shorter hospital stay.
SESSION
E-poster
E-Session 7/27 ~ 7/29 ALL DAY