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REVIEW ARTICLE
Year : 2019  |  Volume : 8  |  Issue : 5  |  Page : 298-309

EUS versus percutaneous management of postoperative pancreatic fluid collection: A systematic review and meta-analysis


1 University of Arizona/Banner University Medical Center, Tucson, USA
2 Rapides Regional Medical Center, Alexandria, Louisiana, USA
3 Department of Hospital Medicine, Carilion Roanoke Memorial Hospital, Roanoke, Virginia, USA
4 Department of Surgical Gastroenterology, Meenakshi Medical College and Research Institute, Kanchipuram, Tamil Nadu, India
5 Division of Gastroenterology and Hepatology, Singapore General Hospital, Singapore
6 Division of Gastroenterology and Hepatology, University of Utah School of Medicine, Salt Lake City, Utah, USA

Correspondence Address:
Dr. Douglas G Adler
Division of Gastroenterology and Hepatology, Huntsman Cancer Center, University of Utah School of Medicine, 30N 1900E 4R118, Salt Lake City, Utah 84132
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/eus.eus_18_19

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Postoperative pancreatic fluid collection (POPFC) is an important complication following abdominal surgery. POPFC causes significant morbidity and mortality. Management options are time-consuming and severely affect patient's quality of life. Surgical and/or percutaneous drainage (PCD) is the traditional mainstay of treatment. Studies have shown that EUS could have a role to play in the management of POPFC. Data are limited in the comparison of clinical outcomes with EUS as compared to PCD to this end. We conducted a comprehensive search of multiple electronic databases and conference proceedings including PubMed, EMBASE, Google Scholar, LILACS, and Web of Science databases (earliest inception through September 2018) to identify studies that reported on the clinical outcomes of EUS and PCD in the management of POPFC. The goals were to estimate and compare the pooled rates of technical success, clinical success, adverse events, and POPFC recurrence with EUS and PCD. A total of 13 studies were included in the analysis. Ten studies (239 patients) used EUS and 6 studies (267 patients) used PCD in the management of POPFC. The pooled rate of clinical success with EUS was 93.2% (95% confidence interval [CI] 88.2–96.2, I2 = 0) and with PCD was 79.8% (95% CI 70–87, I2 = 74). The difference was statistically significant, P = 0.002. Recurrence rate was significantly lower with EUS as compared to PCD (9.4%: 95% CI 5.2–16.5 vs. 25.7%: 95% CI 24.3–41.7; P = 0.02). Pooled rates of technical success and adverse events were similar with EUS and PCD. Our meta-analysis shows that EUS has significantly better clinical outcomes, in terms of clinical success and disease recurrence, in the management of POPFC as compared to PCD.


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