THE ROLE OF ANTIBIOTICS IN ENDOSCOPIC TRANSMURAL DRAINAGE OF POST-INFLAMMATORY PANCREATIC AND PERIPANCREATIC FLUID COLLECTIONS

Aims Assessment of the role of antibiotics in endoscopic transmural drainage of post-inflammatory pancreatic and peripancreatic fluid collections (PPPFCs).

Methods Randomized trial covering study group of 62 patients treated endoscopically due to PPPFCs in 2020 in our medical center. The first group consisted of patients who were receiving empirical intravenous antibiotic therapy during endotherapy. The second group consisted of patients without antibiotic therapy during endoscopic drainage of PPPFCs.

Results 31 patients were included into the first group (walled-off pancreatic necrosis [WOPN]- 51.6%, pseudocyst-48.4%) and 31 patients into the second group (WOPN-58.1%, pseudocyst- 41.9%) (p=NS). Infection of PPPFCs content was stated in 16/31 (51.6%) patients from the first group and in 14/31 (45.2%) patients from the second group (p=NS). Average time of active drainage in the first group was 13.0 (6-21) days and in the second group – 14.0 (7-25) days (p=NS). Total number endoscopic procedures on one patients was on average 3.3 (2-5) in the first group and 3.4 (2-7) in the second group (p=NS). Clinical success of endotherapy of PPPFCs was stated in 29/31 (93.5%) patients from the first group and in 30/31 (96.8%) patients from the second group (p=NS). Complications of endotherapy in the first group were stated in 8/31 (25.8%) patients and in 10/31 (32.3%) patients in the second group (p=NS). Long-term success was stated in 26/31 (83.9%) patients in the first group and in 24/31 (77.4%) patients in the second group (p=NS).

Conclusions No antibiotic therapy is required in cases of efficient endoscopic transmural drainage of sterile and infected PPPFCs.

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Artikel online veröffentlicht:
14. April 2022