title: Endoscopic ultrasonography-guided drainage is an effective and relatively safe treatment for peripancreatic fluid collections in a cohort of 108 symptomatic patients.
abstract: OBJECTIVE
  Endoscopic drainage [i.e. conventional, endoscopic ultrasonography (EUS)-assisted, or EUS-guided] is an accepted treatment modality for symptomatic peripancreatic fluid collections (PFC), but data on the efficacy and safety of EUS-guided drainage performed in a large patient cohort are not widely available. Our aim was to evaluate the clinical success and complication rate of EUS-guided drainage of PFCs and to identify prognostic factors for complications and recurrence of PFCs.
  
  
  METHODS
  A retrospective analysis was carried out of consecutive patients undergoing EUS-guided drainage of a symptomatic PFC in the period 2004-2011. Technical success was defined as the ability to enter and drain a PFC by the placement of one or more double-pigtail stents, whereas clinical success was defined as complete resolution of a PFC on follow-up computed tomography.
  
  
  RESULTS
  In total, 108 patients [56% men, mean age 55 (SD 14) years], underwent EUS-guided drainage of a symptomatic PFC. The procedure was technically successful in 105/108 (97%) patients and a median of 2 (range 1-3) pigtail stents were placed. Clinical success was observed in 87/104 (84%) patients after a median follow-up of 53 (interquartile range 21-130) weeks, whereas PFC recurrence was noted in 15/83 (18%) patients. Complications occurred in 21/105 (20%) patients and procedure-related mortality was not observed. Prognostic factors for complications and recurrence of PFCs could not be identified.
  
  
  CONCLUSIONS
  EUS-guided drainage of PFCs is effective in the majority of patients. Although the complication rate of the procedure is not negligible (20%), they could be managed in almost all patients by conservative and/or endoscopic means and did not result in mortality.
authors.affiliation: Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Hannah T
authors.initials: HT
authors.lastname: Künzli
authors.forename: Robin
authors.initials: R
authors.lastname: Timmer
authors.forename: Matthijs P
authors.initials: MP
authors.lastname: Schwartz
authors.forename: Ben J
authors.initials: BJ
authors.lastname: Witteman
authors.forename: Bas L A M
authors.initials: BL
authors.lastname: Weusten
authors.forename: Martijn G H
authors.initials: MG
authors.lastname: van Oijen
authors.forename: Peter D
authors.initials: PD
authors.lastname: Siersema
authors.forename: Frank P
authors.initials: FP
authors.lastname: Vleggaar
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D004322:Drainage / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D019160:Endosonography / Q000009:adverse effects; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009426:Netherlands; D016017:Odds Ratio; D010182:Pancreatic Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome