Endoscopy 2020; 52(S 01): S190-S191
DOI: 10.1055/s-0040-1704593
ESGE Days 2020 ePoster Podium presentations
Friday, April 24, 2020 15:00 – 15:30 Innovation in enhanced imaging ePoster Podium 3
© Georg Thieme Verlag KG Stuttgart · New York

FUSION RADIOLOGY FOR ENDOSCOPIC DRAINAGE OF PANCREATIC FLUID COLLECTIONS: AN INNOVATIVE SINGLE CENTER EXPERIENCE

R Sassatelli
1   Azienda USL – IRCCS di Reggio Emilia, Reggio Emilia, Italy
,
S Grillo
,
P Cecinato
1   Azienda USL – IRCCS di Reggio Emilia, Reggio Emilia, Italy
,
V Iori
,
G Besutti
1   Azienda USL – IRCCS di Reggio Emilia, Reggio Emilia, Italy
,
M Ottone
1   Azienda USL – IRCCS di Reggio Emilia, Reggio Emilia, Italy
,
PG Rossi
1   Azienda USL – IRCCS di Reggio Emilia, Reggio Emilia, Italy
,
G Sereni
1   Azienda USL – IRCCS di Reggio Emilia, Reggio Emilia, Italy
,
M Cavina
1   Azienda USL – IRCCS di Reggio Emilia, Reggio Emilia, Italy
,
S Arona
1   Azienda USL – IRCCS di Reggio Emilia, Reggio Emilia, Italy
,
F Bassi
1   Azienda USL – IRCCS di Reggio Emilia, Reggio Emilia, Italy
,
MC Campanale
1   Azienda USL – IRCCS di Reggio Emilia, Reggio Emilia, Italy
,
F Decembrino
1   Azienda USL – IRCCS di Reggio Emilia, Reggio Emilia, Italy
,
M Lucarini
1   Azienda USL – IRCCS di Reggio Emilia, Reggio Emilia, Italy
,
VG Mirante
1   Azienda USL – IRCCS di Reggio Emilia, Reggio Emilia, Italy
,
F Parmeggiani
1   Azienda USL – IRCCS di Reggio Emilia, Reggio Emilia, Italy
,
C Tioli
1   Azienda USL – IRCCS di Reggio Emilia, Reggio Emilia, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

 

Aims Virtual reality obtained by the fusion of images can be applied to several fields of medicine leading to the so-called “augmented reality”. Since 2017 we have been using a new digital angiographic system (Discovery IGS 40, General Electrics) in biliopancreatic endoscopy, where fluoroscopy can be fused with pre-procedural CT o MRI. Specifically the present study aimed at verifying the advantages that fusion imaging could bring in EUS-guided drainage of post-pancreatitis fluid collection (PFC), i.e. pseudocysts or WON, in terms of more appropriate visualization, drainage approach and time needed for resolution.

Methods 17 drainages performed with traditional radiology (group 1) were retrospectively compared with 14 ones achieved with fusion approach (group 2). The two population were homogenous for age, sex, pancreatitis etiology and indication for drainage whereas PFCs of group 2 were larger (663 cm3 vs 437 cm3), more frequently WON than pseudocysts and were treated more precociously. As for procedure, in the group 2, thanks to fusion imaging, we didn’t need ever contrast media – that was pivotal with traditional radiology – to adequately define lesion morphology. LAMS (Axios) stents were placed mainly in group 2, while in group 1 other types of stent were used.

Results The procedure of EUS-guided drainages of group 2 (Fusion) were quicker (67 minutes vs 100) (p = 0.01), safer – with a lower rate of complication (14.3% vs 37.5%) – and more effective: indeed 12/14 PCF (85.7%) achieved complete resolution in a shorter time – 67% of them within 90 days – instead only 11/17 collections of group 1 (64.7%) obtained the total emptying, more slowly – 36% within 90 days. The logistic regression showed that PFC attained resolution with OR = 3 (95% CI 0.25–36.77) only if belonging to group 2.

Conclusions In this serie our innovative Fusion imaging approach seems to improve EUS-guided drainage of PFC outcomes.