Abstract
Postoperative fluid collection (POFC) is a challenging complication following pancreatobiliary surgery. Traditional treatment with surgical drainage is associated with significant morbidity, while percutaneous drainage is associated with a higher rate of recurrence and the need for repeated interventions. Studies have shown that endoscopic ultrasound (EUS)-guided drainage may offer a promising solution to this problem. There are limited data on the ideal therapeutic protocol for EUS-guided drainage of POFC including the timing for drainage; type, size, and number of stents to use; and the need for endoscopic debridement and irrigation. Current practices extrapolated from the treatment of pancreatic pseudocysts and walled-off necrosis may not be applicable to POFC. There are increasing data to suggest that drainage procedures may be performed within two weeks after surgery. While most authors advocate the use of double pigtail plastic stents (DPPSs), there have been a number of reports on the use of novel lumen-apposing metal stents (LAMSs), although no direct comparisons have been made between the two.
Highlights
Academic Editors: Gianfranco Alpini, Raymond Tang and Rashid N
Keywords used in the search include “endosonography”, “endoscopic ultrasound”, “EUS”, “drainage”, “post-operative complication”, “post-operative fluid collection”, “pancreatobiliary surgery”, “pancreatectomy”, and “bile duct surgery” alone or in combination
Studies Included in EUS-Guided Drainage versus Percutaneous Drainage in Early Postoperative fluid collection (POFC)
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Postoperative fluid collections (POFCs) are well-recognised adverse events following pancreatobiliary surgery and significantly increase morbidity and mortality. Most commonly, they are due to leaking pancreatic fluid after pancreatectomy [1]. While percutaneous drainage (PD) is associated with good success (80–100%) and low mortality rates (1.4–1.5%) [4], percutaneous catheters require daily care and can be problematic for the patients and their caregivers. They can cause local skin irritation, infection, and fistula formation, compromising patients’ quality of life [3,4]. This review article summarises the existing evidence and recommendations for EUS-guided drainage of POFC and aims to provide directions for future research
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