2024-03-28T08:26:46Zhttps://eprints.lib.hokudai.ac.jp/dspace-oai/requestoai:eprints.lib.hokudai.ac.jp:2115/529262022-11-17T02:08:08Zhdl_2115_20043hdl_2115_137Endoscopic ultrasound-guided transmural drainage for pancreatic fistula or pancreatic duct dilation after pancreatic surgeryOnodera, ManabuKawakami, HiroshiKuwatani, MasakiKudo, TaikiHaba, ShinAbe, YokoKawahata, ShuheiEto, KazunoriNasu, YuyaTanaka, EiichiHirano, SatoshiAsaka, MasahiroEUS-guided drainageEUS-guided transmural drainagePancreatic fistulaPancreatic surgeryStasis of pancreatic juice494Background: Endoscopic ultrasound (EUS)-guided drainage is widely used to manage pancreatic pseudocysts. Several studies have reported the use of EUS-guided drainage for pancreatic fistula and stasis of pancreatic juice caused by stricture of the pancreatic duct after pancreatic resection. Methods: In total, 262 patients underwent surgery involving pancreatic resection in our hospital from April 2005 to March 2010. Ninety patients (34%) developed a grade B or C postoperative pancreatic fistula (POPF) that required additional treatment. We performed EUS-guided transmural drainage (EUS-TD) for six patients (2.1%) with a pancreatic fistula or dilation of the main pancreatic duct visible by EUS. Eighteen patients (6.8%) received percutaneous drainage. The success rates for EUS-TD and percutaneous drainage were compared in a retrospective analysis. Results: EUS-RD was successfully performed without complications in all six cases, with five of the six patients being successfully treated with only one trial of EUS-TD. The final technical success rate was 100% for EUS-TD and for percutaneous drainage. Both the short-term and long-term clinical success rates for EUS-TD were 100%, and those of percutaneous drainage were 61.1% and 83%, respectively. The differences in these rates were not significant (short-term success, P = 0.091; long-term success, P = 0.403). However, the period to clinical success was significantly shorter with EUS-TD (5.8 days) than with percutaneous drainage (30.4 days; P = 0.0013) in our series. Conclusions: EUS-TD appears to be a safe and technically feasible alternative to percutaneous drainage and may be considered a first-line therapy for pancreatic fistulas visible by EUS.Springer New YorkJournal Articleapplication/pdfhttp://hdl.handle.net/2115/52926https://eprints.lib.hokudai.ac.jp/dspace/bitstream/2115/52926/1/SE26-6_1710-1717.pdf0930-2794Surgical Endoscopy266171017172012-06enginfo:pmid/22179480info:doi/10.1007/s00464-011-2097-zThe original publication is available at www.springerlink.comauthor