Outcomes Of Endoscopic Drainage Research Articles

Outcomes of Endoscopic Biliary Drainage in Postsurgical Anatomy Using Endoscopic Ultrasound and Enteroscopy: A Comparative Study

AbstractObjectives Biliary obstruction is a common problem encountered in postsurgical anatomy, which may lead to serious complications if not treated promptly. Endoscopic drainage is a minimally invasive and effective treatment option for such patients. However, the optimal route of endoscopic drainage, either SBE-ERCP (single-balloon enteroscopy with endoscopic retrograde cholangiopancreatography) or EUS-BD (endoscopic ultrasound-guided bile duct drainage), remains controversial. In this study, we aim to evaluate the feasibility and outcomes of endoscopic drainage using these two techniques in postsurgical biliary obstruction over a period of 7 years.Materials and Methods We conducted a retrospective study of patients who underwent endoscopic drainage for postsurgical biliary obstruction using SBE-ERCP or EUS-BD techniques between 2015 and 2022. The demographic details, clinical presentation, procedure duration, number of sessions required, technical success, complications, and change of procedure from SBE-ERCP to EUS-BD or vice versa were recorded.Results Seventy-five patients, predominantly females with a mean age of 48 years, underwent endoscopic drainage. Forty-eight patients underwent SBE drainage and 27 patients underwent EUS-HG (EUS-guided hepaticogastrostomy). The mean duration of procedure (44 vs. 77 minutes), number of complications (4 vs. 5), technical success rate (93.5 vs. 85%), change of procedure (0 vs. 3), and number of sessions (1.1 vs. 1.8) were significantly less in the EUS-HG as compared to SBE-ERCP.Conclusions Endoscopic biliary drainage is feasible, safe, and effective in postsurgical biliary anatomy but requires high technical expertise. The study proposes an algorithm that can be applied in such group of patients to determine the route for choosing the drainage procedure. This requires further validation with a large prospective cohort.

Outcomes of Endoscopic Drainage in Children with Pancreatic Fluid Collections: A Systematic Review and Meta-Analysis.

PurposeEndoscopic drainage is an established treatment modality for adult patients with pancreatic fluid collections (PFCs). Available data regarding the efficacy and safety of endoscopic drainage in pediatric patients are limited. In this systematic review and meta-analysis, we aimed to analyze the outcomes of endoscopic drainage in children with PFCs.MethodsA literature search was performed in Embase, PubMed, and Google Scholar for studies on the outcomes of endoscopic drainage with or without endoscopic ultrasonography (EUS) guidance in pediatric patients with PFCs from inception to May 2021. The study’s primary objective was clinical success, defined as resolution of PFCs. The secondary outcomes included technical success, adverse events, and recurrence rates.ResultsFourteen studies (187 children, 70.3% male) were included in this review. The subtypes of fluid collection included pseudocysts (60.3%) and walled-off necrosis (39.7%). The pooled technical success rates in studies where drainage of PFCs were performed with and without EUS guidance were 95.3% (95% confidence interval [CI], 89.6–98%; I2=0) and 93.9% (95% CI, 82.6–98%; I2=0), respectively. The pooled clinical success after one and two endoscopic interventions were 88.7% (95% CI, 82.7–92.9%; I2=0) and 92.3% (95% CI, 87.4–95.4%; I2=0), respectively. The pooled rate of major adverse events was 6.3% (95% CI, 3.3–11.4%; I2=0). The pooled rate of recurrent PFCs after endoscopic drainage was 10.4% (95% CI, 6.1–17.1%; I2=0).ConclusionEndoscopic drainage is safe and effective in children with PFCs. However, future studies are required to compare endoscopic and EUS-guided drainage of PFCs in children.

ID: 3526710 SAFETY AND OUTCOMES OF PERFORMING EARLY DUAL MODAILITY DRAINAGE (

Acute pancreatitis (AP) can vary in severity and around 5-10% develop necrotizing pancreatitis which can lead to Necrotic Fluid Collections (NFC). In current practice, endoscopic drainage is the primary modality for management of symptomatic NFC. GI society guidelines recommend waiting for 4 weeks from onset of AP before considering endoscopic drainage. There is paucity in information regarding safety and outcomes of endoscopic drainage before 4 weeks. We aimed to compare outcomes and safety in patients undergoing early (< 28 days) versus late drainage of NFC.

Disconnected Pancreatic Duct in Children With Walled OFF Necrosis: Impact on Outcomes of Endoscopic Drainage.

Disconnected pancreatic duct syndrome (DPDS) is frequently encountered in cases with walled off necrosis (WON). The impact of DPDS on the outcomes of pancreatic fluid collections (PFCs) is not well known. In this study, we aim to evaluate the incidence of DPDS and its clinical impact on the outcomes of endoscopic ultrasound (EUS)-guided drainage of PFC in children. All children with symptomatic WON who underwent EUS-guided drainage using metal stents were included in the study. At 4 weeks, pancreatic ductal anatomy was evaluated, and metal stents removed. All the children were followed at regular intervals and evaluated for the recurrence of PFC and the development of new-onset diabetes. A total of 32 children (28 boys, median age 15 years) underwent EUS-guided drainage of WON. Resolution of WON was documented in all children at 4 weeks. Pancreatic ductal anatomy using magnetic resonance retrograde cholangiopancreatography and endoscopic retrograde pancreatography was available in 30 (93.7%) children. Of these, DPDS was documented in 25 (83.3%) children including proximal disconnection in 12 and distal disconnection in 13 children. Recurrent PFC and new-onset diabetes were found in 5 (20%) and 2 (8%) children with DPDS, respectively. Of the 5 recurrences of PFC, endoscopic reintervention was required in 3 children. Majority of the children with DPDS do not develop a symptomatic recurrence of PFC after the removal of cystogastric stents. DPDS may be a risk factor for the development of new-onset diabetes. However, future prospective studies are needed.

888 Outcomes of Endoscopic Drainage of Symptomatic Walled-off Necrosis (WON) Using Lumen Apposing Metallic Stents (LAMS) Compared to Fully Covered Self-Expandable Metallic Stents (FCSEMS) or Double Pigtailed Plastic Stents: A 7-Year Single-Center Experience

888 Outcomes of Endoscopic Drainage of Symptomatic Walled-off Necrosis (WON) Using Lumen Apposing Metallic Stents (LAMS) Compared to Fully Covered Self-Expandable Metallic Stents (FCSEMS) or Double Pigtailed Plastic Stents: A 7-Year Single-Center Experience

A comparative evaluation of outcomes of endoscopic versus percutaneous drainage for symptomatic pancreatic pseudocysts

Endoscopic drainage (ED) and percutaneous drainage (PD) have largely replaced surgical drainage as the initial approach for symptomatic pseudocysts. However, there are few studies comparing ED and PD. To compare the outcomes of ED and PD for symptomatic pseudocysts. Retrospective cohort study. Academic center. Adult patients with symptomatic pseudocysts within ≤ 1 cm of the gastric or duodenal wall who underwent ED or PD between 1993 and 2011. Patients with walled-off pancreatic necrosis were excluded. ED or PD. Rates of technical success, procedural adverse events, clinical success, reinterventions, and failure. Other outcomes included the length of hospital stay and number of follow-up abdominal imaging studies. There were 81 patients, 41 who underwent ED and 40 who underwent PD, with no differences in age, sex, and comorbidity between the 2 groups. There were no differences in the rates of technical success (90.2% vs 97.5%; P = .36), adverse events (14.6% vs 15%; P = .96), and clinical success (70.7% vs 72.5%; P = .86) between ED and PD, respectively. Patients who underwent PD had higher rates of reintervention (42.5% vs 9.8%; P = .001), longer length of hospital stay (14.8 ± 14.4 vs 6.5 ± 6.7 days; P = .001), and median number [quartiles] of follow-up abdominal imaging studies (6 [3.25, 10] vs 4 [2.5, 6]; P = .02) compared with patients who underwent ED. Single center, retrospective study. ED and PD have similar clinical success rates for symptomatic pseudocysts. However, PD is associated with significantly higher rates of reintervention, longer length of hospital stay, and increased number of follow-up abdominal imaging studies.

A Hybrid Endoscopic Technique for the Treatment of Walled-off Pancreatic Necrosis

To the Editor: Although the treatment outcomes of endoscopic drainage are excellent for the management of pancreatic pseudocysts, the success rate is significantly less for walled-off pancreatic necrosis (WOPN) (1). Therefore, several minimally invasive techniques, such as (i) endoscopic necrosectomy or (ii) a hybrid approach that combines endoscopy and percutaneous techniques or a combination of laparoscopy and endoscopy, have been devised to facilitate better drainage of necrotic contents. We present our experience with a new hybrid approach that combines percutaneous stent placement to facilitate laparoscopic/endoscopic debridement of necrosis with creation of multiple transluminal gateways in the stomach under endoscopic ultrasound (EUS)-guidance to facilitate better drainage of the necrotic contents.

Long-term outcome of endoscopic drainage of pancreatic pseudocysts.

Long-term outcome of endoscopic drainage of pancreatic pseudocysts.

Long-term outcome of endoscopic drainage of pancreatic pseudocysts

Long-term outcome of endoscopic drainage of pancreatic pseudocysts

Long-term outcome of endoscopic drainage of pancreatic pseudocysts

Long-term outcome of endoscopic drainage of pancreatic pseudocysts