LONG-TERM OUTCOMES AFTER EUS-GUIDED PANCREATIC DUCT DRAINAGE

Aims To analyze the long-term clinical success of EUS-PD

Methods For this retrospective single tertiary-referral center study, data from patients with EUS-PD were collected in patient’s charts and the endoscopy database, retrieving information on indication, technique of drainage, technical and clinical successes (total in case of no pain after treatment, and partial if more than 50% reduction in pain), adverse events, as well as reasons for failure defined as no improvement of (pain) symptoms, or need for surgery.

Results A total of 66 patients were retrieved (62% male, median age 53y; range, 9-79). EUS-PD was performed by transgastric (n=40), transduodenal (n=4) approach, or rendez-vous technique (n=21). Technical success was obtained in 82% (54/66), with an adverse event rate of 30% (20/66), of which one severe and 9 moderate (mostly pancreatitis and fluid effusions).

Long-term clinical success was observed for 46 patients (n=46/54, 85.2%), during a median follow-up of 70 m (range 1-250). One or two stent exchanges were usually needed (median 1.7; range, 0-15). Three patients only underwent surgery. Higher clinical and technical success rates were associated with a large MPD diameter (p=0,008), and male gender (p=0,001). There was no significant relationship between the primary disease, drainage type, tobacco or alcohol use, and technical and clinical success rate.

Conclusions EUS-guided pancreatic drainage is effective in the long term with a clinical success rate over 85%, and may therefore be considered as a good alternative to surgery. However, this technique is still challenging with 18% technical failures, even in an expert center.

Publication History

Article published online:
14 April 2022