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Open Access 28-11-2023 | Acute Pancreatitis | Review Article

Early versus delayed EUS-guided drainage for postoperative pancreatic fluid collections: a systematic review and meta-analysis

Authors: Tsuyoshi Mukai, Yousuke Nakai, Tsuyoshi Hamada, Saburo Matsubara, Takashi Sasaki, Hirotoshi Ishiwatari, Susumu Hijioka, Hideyuki Shiomi, Mamoru Takenaka, Takuji Iwashita, Atsuhiro Masuda, Tomotaka Saito, Hiroyuki Isayama, Ichiro Yasuda, for the WONDERFUL Study Group in Japan

Published in: Surgical Endoscopy | Issue 1/2024

Abstract

Background

Postoperative pancreatic fluid collections (POPFCs) are common adverse events (AEs) after pancreatic surgery and may need interventions. Endoscopic ultrasound (EUS)-guided drainage for POPFCs is increasingly reported, but its appropriate timing has not been fully elucidated. The aim of this meta-analysis was to evaluate treatment outcomes of POPFCs according to the timing of EUS-guided drainage.

Methods

Using PubMed, Embase, Web of Science, and the Cochrane database, we identified clinical studies published until December 2022 with data comparing outcomes of early and delayed EUS-guided drainage for POPFCs. We pooled data on AEs, mortality, and technical and clinical success rates, using the random-effects model.

Results

From 1415 papers identified in the initial literature search, we identified 6 retrospective studies, including 128 and 107 patients undergoing early and delayed EUS-guided drainage for POPFCs. The threshold of early and delayed drainage ranged from 14 to 30 days. Distal pancreatectomy was the major cause of POPFCs, ranging from 44 to 100%. The pooled odds ratio (OR) for AEs was 0.81 (95% confidence interval [CI] 0.40–1.64, P = 0.55) comparing early to delayed drainage. There was no procedure-related mortality. Technical success was achieved in all cases and a pooled OR of clinical success was 0.60 (95% CI 0.20–1.83, P = 0.37).

Conclusion

POPFCs can be managed by early EUS-guided drainage without an increase in AEs.

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Title: Early versus delayed EUS-guided drainage for postoperative pancreatic fluid collections: a systematic review and meta-analysis
Authors: Tsuyoshi Mukai
Yousuke Nakai
Tsuyoshi Hamada
Saburo Matsubara
Takashi Sasaki
Hirotoshi Ishiwatari
Susumu Hijioka
Hideyuki Shiomi
Mamoru Takenaka
Takuji Iwashita
Atsuhiro Masuda
Tomotaka Saito
Hiroyuki Isayama
Ichiro Yasuda
for the WONDERFUL Study Group in Japan
Publication date: 28-11-2023
Publisher: Springer US
Keywords: Acute Pancreatitis
Pancreatectomy
Published in: Surgical Endoscopy / Issue 1/2024
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-023-10568-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Early versus delayed EUS-guided drainage for postoperative pancreatic fluid collections: a systematic review and meta-analysis

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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