Coluccio Chiara, Tarantino Ilaria, Petrone Maria Chiara, Forti Edoardo, Crinò Stefano Francesco, Fugazza Alessandro, Di Mitri Roberto, Binda Cecilia, Trama Davide, Amato Arnaldo, Redaelli Alessandro, De Nucci Germana, Attili Fabia, Brancaccio Mario Luciano, De Angelis Claudio Giovanni, Lovera Mauro, Facciorusso Antonio, Anderloni Andrea, Fabbri Carlo
Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, AUSL Romagna, 47121 Forlì-Cesena, Italy.
Endoscopy Service, Department of Diagnostic and Therapeutic Services, IRCCS-ISMETT, 90100 Palermo, Italy.
Diagnostics (Basel). 2025 May 15;15(10):1258. doi: 10.3390/diagnostics15101258.
Postoperative fluid collections (POFCs) after abdominal surgeries, particularly pancreatic surgeries, are associated with high morbidity and mortality rates and were historically managed with surgical re-exploration and drainage. In particular, postoperative pancreatic fluid collections (PPFCs) are the most common complications after pancreatic surgery resulting from pancreatic leaks. They occur in up to 50% of cases, and approximately 10% of them need to be drained to avoid further sequelae. Endoscopic ultrasonography (EUS)-guided drainage of PPFCs represents the first-line treatment nowadays, but many aspects are still debated. We describe a retrospective case series of patients from multiple Italian centers who underwent EUS-guided drainage (EUS-D) of POFCs, aiming to provide data on the efficacy and safety of this procedure, supported by a review of the existing literature on this topic. The primary outcomes were technical and clinical success, and the secondary outcomes were the type and rate of adverse events (AEs) and the rate of recurrence. A total of 47 patients were included. The procedure demonstrated a technical success rate of 98% (46/47) and a clinical success rate of 96% (45/47). The rate of AEs was 11% (5/47), represented by bleeding (3/5), stent occlusion (1/5), and buried syndrome (1/5). Management of POFCs has shifted over time towards an endoscopic approach with optimal efficacy and safety.
腹部手术后的术后积液（POFCs），尤其是胰腺手术后的积液，与高发病率和死亡率相关，过去一直通过手术再次探查和引流进行处理。特别是，术后胰液积聚（PPFCs）是胰腺手术后因胰漏导致的最常见并发症。它们在高达50%的病例中出现，其中约10%需要引流以避免进一步的后遗症。如今，内镜超声（EUS）引导下的PPFCs引流是一线治疗方法，但许多方面仍存在争议。我们描述了一个来自多个意大利中心的患者回顾性病例系列，这些患者接受了EUS引导下的POFCs引流（EUS-D），旨在通过回顾关于该主题的现有文献，提供该手术有效性和安全性的数据。主要结局是技术成功和临床成功，次要结局是不良事件（AEs）的类型和发生率以及复发率。总共纳入了47例患者。该手术的技术成功率为98%（46/47），临床成功率为96%（45/47）。AEs发生率为11%（5/47），包括出血（3/5）、支架阻塞（1/5）和埋入综合征（1/5）。随着时间的推移，POFCs的管理已转向具有最佳有效性和安全性的内镜治疗方法。
