| Title: | Endoscopic ultrasound-guided transmural drainage for pancreatic fistula or pancreatic duct dilation after pancreatic surgery |
| Authors: | Onodera, Manabu Browse this author |
| Kawakami, Hiroshi Browse this author →KAKEN DB |
| Kuwatani, Masaki Browse this author →KAKEN DB |
| Kudo, Taiki Browse this author |
| Haba, Shin Browse this author |
| Abe, Yoko Browse this author |
| Kawahata, Shuhei Browse this author |
| Eto, Kazunori Browse this author |
| Nasu, Yuya Browse this author |
| Tanaka, Eiichi Browse this author |
| Hirano, Satoshi Browse this author →KAKEN DB |
| Asaka, Masahiro Browse this author →KAKEN DB |
| Keywords: | EUS-guided drainage |
| EUS-guided transmural drainage |
| Pancreatic fistula |
| Pancreatic surgery |
| Stasis of pancreatic juice |
| Issue Date: | Jun-2012 |
| Publisher: | Springer New York |
| Journal Title: | Surgical Endoscopy |
| Volume: | 26 |
| Issue: | 6 |
| Start Page: | 1710 |
| End Page: | 1717 |
| Publisher DOI: | 10.1007/s00464-011-2097-z |
| PMID: | 22179480 |
| Abstract: | Background: 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. |
| Rights: | The original publication is available at www.springerlink.com |
| Type: | article (author version) |
| URI: | http://hdl.handle.net/2115/52926 |
| Appears in Collections: | 北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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