Endoscopic transmural drainage of postoperative intra-abdominal abscesses.
EAES Academy. Jagielski M. 07/05/22; 363003; P046
Prof. Dr. Mateusz Jagielski
Contributions
Contributions
Abstract
Aims:
Currently, endoscopic transmural drainage is a common method of treatment of post-inflammatory pancreatic fluid collections. Use of endoscopic ultrasonography in transmural drainage makes access through the wall of gastrointestinal tract to other pathological fluid collections possible, including postoperative intra-abdominal abscesses (PIAAs). Assessment of usefulness of endoscopic transmural drainage in treatment of PIAAs.
Methods:
Retrospective assessment of endotherapy results’ in all 29 patients with PIAAs in years 2018-2021 in the Department of General, Gastroenterological and Oncological Surgery, Collegium Medicum, Nicolaus Copernicus University in Toruń, Poland. Patients were divided into two groups depending on period between the surgery and beginning of endoscopic treatment. The 1.group consisted of patients who underwent endoscopic transmural drainage of PIAAs during first two weeks after the surgery. The 2.group consisted of patients in whom endotherapy began two weeks after the surgery or later.
Results:
In all 29 patients active transmural (transgastric) endoscopic drainage through single approach was performed. The 1.group consisted of 16/29 (55.17%) patients with PIAAs, the 2.group consisted of 13/29 (44.83%) patients with PIAAs. In both groups PIAAs were complications of urgent laparotomy due to purulent or fecal peritonitis caused by pathology in the large intestine (81.25% vs 76.92%, p=NS). The active transmural endoscopic drainage lasted 7 (5-12) days in the 1.group and 13 (7-22) days in the 2.group (p<0.05). Complications of endotherapy were stated in 3/16 (18.75%) patients in the 1.group and in 2/13 (15.38%) patients in the 2.group (p=NS). Clinical success was achieved in 15/16 (93.75%) patients from the 1.group and in 10/13 (76.92%) patients from the 2.group (p=NS). Long-term success was stated in 14/16 (87.5%) from the 1.group and in 9/13 (69.23%) patients from the 2.group (p<0.05).
Conclusion:
Endoscopic transmural drainage is an effective method of treatment of PIAAs. An early endoscopic drainage results in better outcomes of treatment in this group of patients.
Currently, endoscopic transmural drainage is a common method of treatment of post-inflammatory pancreatic fluid collections. Use of endoscopic ultrasonography in transmural drainage makes access through the wall of gastrointestinal tract to other pathological fluid collections possible, including postoperative intra-abdominal abscesses (PIAAs). Assessment of usefulness of endoscopic transmural drainage in treatment of PIAAs.
Methods:
Retrospective assessment of endotherapy results’ in all 29 patients with PIAAs in years 2018-2021 in the Department of General, Gastroenterological and Oncological Surgery, Collegium Medicum, Nicolaus Copernicus University in Toruń, Poland. Patients were divided into two groups depending on period between the surgery and beginning of endoscopic treatment. The 1.group consisted of patients who underwent endoscopic transmural drainage of PIAAs during first two weeks after the surgery. The 2.group consisted of patients in whom endotherapy began two weeks after the surgery or later.
Results:
In all 29 patients active transmural (transgastric) endoscopic drainage through single approach was performed. The 1.group consisted of 16/29 (55.17%) patients with PIAAs, the 2.group consisted of 13/29 (44.83%) patients with PIAAs. In both groups PIAAs were complications of urgent laparotomy due to purulent or fecal peritonitis caused by pathology in the large intestine (81.25% vs 76.92%, p=NS). The active transmural endoscopic drainage lasted 7 (5-12) days in the 1.group and 13 (7-22) days in the 2.group (p<0.05). Complications of endotherapy were stated in 3/16 (18.75%) patients in the 1.group and in 2/13 (15.38%) patients in the 2.group (p=NS). Clinical success was achieved in 15/16 (93.75%) patients from the 1.group and in 10/13 (76.92%) patients from the 2.group (p=NS). Long-term success was stated in 14/16 (87.5%) from the 1.group and in 9/13 (69.23%) patients from the 2.group (p<0.05).
Conclusion:
Endoscopic transmural drainage is an effective method of treatment of PIAAs. An early endoscopic drainage results in better outcomes of treatment in this group of patients.
Aims:
Currently, endoscopic transmural drainage is a common method of treatment of post-inflammatory pancreatic fluid collections. Use of endoscopic ultrasonography in transmural drainage makes access through the wall of gastrointestinal tract to other pathological fluid collections possible, including postoperative intra-abdominal abscesses (PIAAs). Assessment of usefulness of endoscopic transmural drainage in treatment of PIAAs.
Methods:
Retrospective assessment of endotherapy results’ in all 29 patients with PIAAs in years 2018-2021 in the Department of General, Gastroenterological and Oncological Surgery, Collegium Medicum, Nicolaus Copernicus University in Toruń, Poland. Patients were divided into two groups depending on period between the surgery and beginning of endoscopic treatment. The 1.group consisted of patients who underwent endoscopic transmural drainage of PIAAs during first two weeks after the surgery. The 2.group consisted of patients in whom endotherapy began two weeks after the surgery or later.
Results:
In all 29 patients active transmural (transgastric) endoscopic drainage through single approach was performed. The 1.group consisted of 16/29 (55.17%) patients with PIAAs, the 2.group consisted of 13/29 (44.83%) patients with PIAAs. In both groups PIAAs were complications of urgent laparotomy due to purulent or fecal peritonitis caused by pathology in the large intestine (81.25% vs 76.92%, p=NS). The active transmural endoscopic drainage lasted 7 (5-12) days in the 1.group and 13 (7-22) days in the 2.group (p<0.05). Complications of endotherapy were stated in 3/16 (18.75%) patients in the 1.group and in 2/13 (15.38%) patients in the 2.group (p=NS). Clinical success was achieved in 15/16 (93.75%) patients from the 1.group and in 10/13 (76.92%) patients from the 2.group (p=NS). Long-term success was stated in 14/16 (87.5%) from the 1.group and in 9/13 (69.23%) patients from the 2.group (p<0.05).
Conclusion:
Endoscopic transmural drainage is an effective method of treatment of PIAAs. An early endoscopic drainage results in better outcomes of treatment in this group of patients.
Currently, endoscopic transmural drainage is a common method of treatment of post-inflammatory pancreatic fluid collections. Use of endoscopic ultrasonography in transmural drainage makes access through the wall of gastrointestinal tract to other pathological fluid collections possible, including postoperative intra-abdominal abscesses (PIAAs). Assessment of usefulness of endoscopic transmural drainage in treatment of PIAAs.
Methods:
Retrospective assessment of endotherapy results’ in all 29 patients with PIAAs in years 2018-2021 in the Department of General, Gastroenterological and Oncological Surgery, Collegium Medicum, Nicolaus Copernicus University in Toruń, Poland. Patients were divided into two groups depending on period between the surgery and beginning of endoscopic treatment. The 1.group consisted of patients who underwent endoscopic transmural drainage of PIAAs during first two weeks after the surgery. The 2.group consisted of patients in whom endotherapy began two weeks after the surgery or later.
Results:
In all 29 patients active transmural (transgastric) endoscopic drainage through single approach was performed. The 1.group consisted of 16/29 (55.17%) patients with PIAAs, the 2.group consisted of 13/29 (44.83%) patients with PIAAs. In both groups PIAAs were complications of urgent laparotomy due to purulent or fecal peritonitis caused by pathology in the large intestine (81.25% vs 76.92%, p=NS). The active transmural endoscopic drainage lasted 7 (5-12) days in the 1.group and 13 (7-22) days in the 2.group (p<0.05). Complications of endotherapy were stated in 3/16 (18.75%) patients in the 1.group and in 2/13 (15.38%) patients in the 2.group (p=NS). Clinical success was achieved in 15/16 (93.75%) patients from the 1.group and in 10/13 (76.92%) patients from the 2.group (p=NS). Long-term success was stated in 14/16 (87.5%) from the 1.group and in 9/13 (69.23%) patients from the 2.group (p<0.05).
Conclusion:
Endoscopic transmural drainage is an effective method of treatment of PIAAs. An early endoscopic drainage results in better outcomes of treatment in this group of patients.
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