Original ArticleEndoscopic drainage of pancreatic-fluid collections in 116 patients: a comparison of etiologies, drainage techniques, and outcomes
Section snippets
Patients and methods
All attempted endoscopic pancreatic-fluid collection drainages between January 1999 and December 2003 were identified by review of an examination log that contains a record of all therapeutic biliary and pancreatic endoscopy procedures. This period was chosen, because it was after the introduction of therapeutic echoendoscopes, which allow EUS-guided transmural drainage of PFC, including nasocystic and/or stent placement, without the need to exchange endoscopes (except for placement of large
Results
Etiology of the collections included AP (n = 47), CP (n = 66), and pancreatic surgery for benign tumors (n = 3). Baseline characteristics of the patients with AP and CP are shown in Table 1. Patients with CP had significantly lower body mass index (AP vs. CP, 24.1 vs. 20.2, p < 0.0001) and C-reactive protein before the procedure (AP vs. CP, 12.2 vs. 1.8 mg/dL, p < 0.0001) than AP patients. Three patients underwent drainage of collections that occurred because of ductal disruption after surgical
Discussion
Although drainage of PFCs can be performed by endoscopic, surgical, and/or percutaneous means, only by using endoscopy do we have the potential to perform an effective internal drainage with a rapid recovery time and, in addition, provide the option of pancreatic-duct drainage. While several reports have suggested similar success rates with open surgical drainage, it seems to be at the cost of higher mortality and morbidity rates.11, 12, 23, 24, 25 The exception to this may be patients with CP
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L. Hookey receives support from the Canadian Association of Gastroenterology/Solvay/CIHR research fellowship.
See CME section; p. 677.