Management of Postoperative Pancreatic Fluid Collection and Role of Endoscopy: A Case Series and Review of the Literature

Background: Postoperative fluid collections (POFCs) after abdominal surgeries, particularly pancreatic surgeries, are associated with high morbidity and mortality rates and were historically managed with surgical re-exploration and drainage. In particular, postoperative pancreatic fluid collections...

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Published in:Diagnostics (Basel) Vol. 15; no. 10; p. 1258
Main Authors: Coluccio, Chiara, Tarantino, Ilaria, Petrone, Maria Chiara, Forti, Edoardo, Crinò, Stefano Francesco, Fugazza, Alessandro, Di Mitri, Roberto, Binda, Cecilia, Trama, Davide, Amato, Arnaldo, Redaelli, Alessandro, De Nucci, Germana, Attili, Fabia, Brancaccio, Mario Luciano, De Angelis, Claudio Giovanni, Lovera, Mauro, Facciorusso, Antonio, Anderloni, Andrea, Fabbri, Carlo
Format: Journal Article
Language:English
Published: Switzerland MDPI AG 15.05.2025
MDPI
Subjects:
Abdomen
Abdominal surgery
Asymptomatic
Cysts
Data collection
Diagnostic imaging
endoscopic ultrasound-guided drainage (EUS-D)
Endoscopy
Fistula
Health aspects
Infections
Italy
Leukocytes
Medical imaging
Mortality
Pancreatectomy
pancreatic fluid collection (PFC)
Patients
percutaneous drainage (PCD)
postoperative fluid collection (POFC)
postoperative pancreatic fluid collection (PPFC)
Stents
Success
Ultrasonic imaging
Italy
percutaneous drainage (PCD)
pancreatic fluid collection (PFC)
endoscopic ultrasound-guided drainage (EUS-D)
postoperative fluid collection (POFC)
postoperative pancreatic fluid collection (PPFC)
ISSN:2075-4418, 2075-4418
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Summary:Background: Postoperative fluid collections (POFCs) after abdominal surgeries, particularly pancreatic surgeries, are associated with high morbidity and mortality rates and were historically managed with surgical re-exploration and drainage. In particular, postoperative pancreatic fluid collections (PPFCs) are the most common complications after pancreatic surgery resulting from pancreatic leaks. They occur in up to 50% of cases, and approximately 10% of them need to be drained to avoid further sequelae. Endoscopic ultrasonography (EUS)-guided drainage of PPFCs represents the first-line treatment nowadays, but many aspects are still debated. Methods: We describe a retrospective case series of patients from multiple Italian centers who underwent EUS-guided drainage (EUS-D) of POFCs, aiming to provide data on the efficacy and safety of this procedure, supported by a review of the existing literature on this topic. The primary outcomes were technical and clinical success, and the secondary outcomes were the type and rate of adverse events (AEs) and the rate of recurrence. Results: A total of 47 patients were included. The procedure demonstrated a technical success rate of 98% (46/47) and a clinical success rate of 96% (45/47). The rate of AEs was 11% (5/47), represented by bleeding (3/5), stent occlusion (1/5), and buried syndrome (1/5). Conclusions: Management of POFCs has shifted over time towards an endoscopic approach with optimal efficacy and safety.
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ISSN:2075-4418
2075-4418
DOI:10.3390/diagnostics15101258