دورية أكاديمية
أعرض في EDS

An international multicenter study comparing EUS-guided pancreatic duct drainage with enteroscopy-assisted endoscopic retrograde pancreatography after Whipple surgery.

التفاصيل البيبلوغرافية
العنوان: An international multicenter study comparing EUS-guided pancreatic duct drainage with enteroscopy-assisted endoscopic retrograde pancreatography after Whipple surgery.
المؤلفون: Chen YI; Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA., Levy MJ; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA., Moreels TG; Division of Gastroenterology and Hepatology, Cliniques Universitaires Saint-Luc, Brussels, Belgium., Hajijeva G; Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA., Will U; Division of Gastroenterology and Hepatology, Municipal Hospital, Gera, Germany., Artifon EL; Department of Surgery, Ana Costa Hospital, Santos, Brazil., Hara K; Division of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan., Kitano M; Divisions of Gastroenterology and Hepatology, Kinki University Faculty of Medicine, Osaka, Japan., Topazian M; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA., Abu Dayyeh B; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA., Reichel A; Division of Gastroenterology and Hepatology, Municipal Hospital, Gera, Germany., Vilela T; Department of Surgery, Ana Costa Hospital, Santos, Brazil., Ngamruengphong S; Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA., Haito-Chavez Y; Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA., Bukhari M; Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA., Okolo P 3rd; Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA., Kumbhari V; Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA., Ismail A; Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA., Khashab MA; Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
المصدر: Gastrointestinal endoscopy [Gastrointest Endosc] 2017 Jan; Vol. 85 (1), pp. 170-177. Date of Electronic Publication: 2016 Jul 25.
نوع المنشور: Comparative Study; Journal Article; Multicenter Study
اللغة: English
بيانات الدورية: Publisher: Mosby Yearbook Country of Publication: United States NLM ID: 0010505 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-6779 (Electronic) Linking ISSN: 00165107 NLM ISO Abbreviation: Gastrointest Endosc Subsets: MEDLINE
أسماء مطبوعة: Publication: St Louis, Mo : Mosby Yearbook
Original Publication: Denver.
مواضيع طبية MeSH: Cholangiopancreatography, Endoscopic Retrograde/*methods , Drainage/*methods , Pancreatic Ducts/*pathology , Pancreatic Ducts/*surgery , Pancreaticoduodenectomy/*adverse effects , Postoperative Complications/*therapy, Adult ; Aged ; Anastomosis, Surgical/adverse effects ; Cholangiopancreatography, Endoscopic Retrograde/adverse effects ; Constriction, Pathologic/etiology ; Constriction, Pathologic/therapy ; Dilatation ; Drainage/adverse effects ; Endoscopy, Gastrointestinal ; Endosonography ; Female ; Humans ; Length of Stay ; Male ; Middle Aged ; Operative Time ; Postoperative Complications/etiology ; Retrospective Studies ; Stents ; Treatment Outcome ; Ultrasonography, Interventional/adverse effects
مستخلص: Background and Aims: Endoscopic management of post-Whipple pancreatic adverse events (AEs) with enteroscopy-assisted endoscopic retrograde pancreatography (e-ERP) is associated with high failure rates. EUS-guided pancreatic duct drainage (EUS-PDD) has shown promising results; however, no comparative data have been done for these 2 modalities. The goal of this study is to compare EUS-PDD with e-ERP in terms of technical success (PDD through dilation/stent), clinical success (improvement/resolution of pancreatic-type symptoms), and AE rates in patients with post-Whipple anatomy.
Methods: This is an international multicenter comparative retrospective study at 7 tertiary centers (2 United States, 2 European, 2 Asian, and 1 South American). All consecutive patients who underwent EUS-PDD or e-ERP between January 2010 and August 2015 were included.
Results: In total, 66 patients (mean age, 57 years; 48% women) and 75 procedures were identified with 40 in EUS-PDD and 35 in e-ERP. Technical success was achieved in 92.5% of procedures in the EUS-PDD group compared with 20% of procedures in the e-ERP group (OR, 49.3; P < .001). Clinical success (per patient) was attained in 87.5% of procedures in the EUS-PDD group compared with 23.1% in the e-ERP group (OR, 23.3; P < .001). AEs occurred more commonly in the EUS-PDD group (35% vs 2.9%, P < .001). However, all AEs were rated as mild or moderate. Procedure time and length of stay were not significantly different between the 2 groups.
Conclusions: EUS-PDD is superior to e-ERP in post-Whipple anatomy in terms of efficacy with acceptable safety. As such, EUS-PDD should be considered as a potential first-line treatment in post-pancreaticoduodenectomy anatomy when necessary expertise is available.
(Copyright © 2017 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.)
التعليقات: Comment in: Gastrointest Endosc. 2017 Jan;85(1):178-180. (PMID: 27986109)
Comment in: Gastrointest Endosc. 2017 Oct;86(4):747-748. (PMID: 28917352)
Comment in: Gastrointest Endosc. 2017 Oct;86(4):748-749. (PMID: 28917353)
تواريخ الأحداث: Date Created: 20160728 Date Completed: 20170914 Latest Revision: 20171030
رمز التحديث: 20231215
DOI: 10.1016/j.gie.2016.07.031
PMID: 27460390
قاعدة البيانات: MEDLINE
الوصف
تدمد:1097-6779
DOI:10.1016/j.gie.2016.07.031