title: Postoperative abdominal collections drainage: Percutaneous versus guided by endoscopic ultrasound.
abstract: OBJECTIVE
  Postoperative fluid collections (POFC) have high mortality. Percutaneous drainage (PD) is the preferred treatment modality. Drainage guided by endoscopic ultrasound (EUS-GD) represents a good alternative. The aim of the present study was to compare clinical success and complication rates of EUS-GD versus PD.
  
  
  METHODS
  Data collected prospectively were analyzed in a retrospective manner. Patients with POFC from October 2008 to November 2013 were included. All collections were drained percutaneously or by EUS-GD.
  
  
  RESULTS
  Sixty-three procedures in 43 patients with POFC were analyzed; 13 patients were drained using EUS-GD and 32 patients with PD. Two patients assigned initially to the PD group were reassigned to EUS-GD. Surgery procedures most often related to the collections were intestinal reconnection, distal pancreatectomy, biliary-digestive bypass, and exploratory laparotomy. Technical success (100% vs 91%; P = 0.25), clinical success (100% vs 84%; P = 0.13), recurrence (31% vs 25%; P = 0.69), hospital stay days (median 22 vs 27; P = 0.35), total costs (8328 ± 1600 USD vs 11 047 ± 1206 USD; P = 0.21), complications (0% vs 6%; P = 0.3), and mortality (8% vs 6%; P = 0.9) were each evaluated in the EUS-GD and PD groups, respectively. In the PD group one death was related to the procedure.
  
  
  CONCLUSIONS
  EUS-GD is as effective and safe as PD in patients with POFC. The advantage of not requiring external drainage and a trend to higher clinical success and lower total costs must be considered.
authors: Gastrointestinal Endoscopy Department, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico.
authors: Félix
authors: F
authors: Téllez-Ávila
authors: Gastrointestinal Endoscopy Department, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico.
authors: Guillermo Jesús
authors: GJ
authors: Carmona-Aguilera
authors: Gastrointestinal Endoscopy Department, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico.
authors: Francisco
authors: F
authors: Valdovinos-Andraca
authors: Gastrointestinal Endoscopy Department, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico.
authors: Luis Eduardo
authors: LE
authors: Casasola-Sánchez
authors: Imaging Department, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico.
authors: Adrían
authors: A
authors: González-Aguirre
authors: Imaging Department, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico.
authors: Ivan
authors: I
authors: Casanova-Sánchez
authors: Gastrointestinal Endoscopy Department, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico.
authors: Javier
authors: J
authors: Elizondo-Rivera
authors: Gastrointestinal Endoscopy Department, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico.
authors: Miguel Ángel
authors: MÁ
authors: Ramírez-Luna
mesh_terms: D034841:Abdominal Cavity / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D004322:Drainage / Q000379:methods*; D019160:Endosonography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted / Q000379:methods*; D055815:Young Adult
keywords: abdominal collection; endoscopic ultrasound-guided drainage; endoscopy treatment; postsurgical collection; radiology intervention