| Title: | A drainage strategy for postoperative pancreatic fistula after left-sided pancreatectomy based on the wall status of collected fluid |
| Authors: | Kuwatani, Masaki Browse this author →KAKEN DB |
| Imamura, Masafumi Browse this author →KAKEN DB |
| Hayashi, Tsuyoshi Browse this author →KAKEN DB |
| Yoshida, Makoto Browse this author →KAKEN DB |
| Kimura, Yasutoshi Browse this author →KAKEN DB |
| Asano, Toshimichi Browse this author →KAKEN DB |
| Nakamura, Toru Browse this author →KAKEN DB |
| Motoya, Masayo Browse this author →KAKEN DB |
| Yoshida, Makoto Browse this author →KAKEN DB |
| Noji, Takehiro Browse this author →KAKEN DB |
| Okamura, Keisuke Browse this author →KAKEN DB |
| Takahashi, Kuniyuki Browse this author |
| Katanuma, Akio Browse this author |
| Hirano, Satoshi Browse this author →KAKEN DB |
| Keywords: | Pancreatic fistula |
| Endoscopic ultrasonography |
| Percutaneous drainage |
| Pancreatectomy |
| Resection |
| Issue Date: | May-2021 |
| Publisher: | Springer |
| Journal Title: | Langenbeck's archives of surgery |
| Volume: | 406 |
| Issue: | 3 |
| Start Page: | 743 |
| End Page: | 751 |
| Publisher DOI: | 10.1007/s00423-020-02067-8 |
| Abstract: | Purpose Postoperative pancreatic fistula (POPF) after pancreatectomy is one of the severe postoperative adverse events. We aimed to clarify the outcomes of a strategy for POPF after left-sided pancreatectomy with one-step endoscopic ultrasonography-guided drainage (EUSD) and percutaneous drainage (PCD) based on the wall status of collected fluid. Methods From January 2012 to September 2017, 90 of 336 patients developed grade B/C POPF and were retrospectively analyzed. Primary outcome measures were the technical and clinical success and resolution rates. Secondary outcome measures were time from surgery to intervention, and time from intervention to discharge/resolution or stent/tube removal and adverse events. Results Seventeen patients underwent EUSD and 73 patients underwent PCD for POPF. The technical success rates were 100% in both the EUSD and PCD groups. The clinical success and resolution rates in the EUSD group were 100%, while those in the PCD group were 98.6%. The time from surgery to intervention was significantly longer in the EUSD group than in the PCD group (20 vs. 11 days, p < 0.001). The time from intervention to discharge/resolution was significantly shorter in the EUSD group than in the PCD group (11 vs. 22 days, p < 0.001/10 vs. 20 days, p < 0.001). The time from intervention to stent/tube removal was significantly shorter in the PCD group than in the EUSD group (20.5 vs. 873 days, p < 0.001). Adverse event rates were similar in the two groups (11.8% vs. 5.5%). Conclusion A drainage strategy for POPF based on the wall status of collected fluid is appropriate. |
| Rights: | This is a post-peer-review, pre-copyedit version of an article published in Langenbeck's archives of surgery. The final authenticated version is available online at: http://dx.doi.org/10.1007/s00423-020-02067-8 |
| Type: | article (author version) |
| URI: | http://hdl.handle.net/2115/85244 |
| 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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