Detailed Abstract
[E-poster - Biliary & Pancreas (Pancreas Disease/Surgery)]
[EP 251] Efficacy of endoscopic ultrasound-guided transmural pancreatic duct drainage (EUS-PDD) in a multicenter study in Taiwan (Taiwan EUS-BPD Study Group)
Chi Ko1, Yu-Ting Kuo1, Hsiang Yao Shih2, Jung-Chun Lin3, Chia-Hsien Wu4, Cheng-Lin Hsieh5, Hsiu-Po Wang6, Hsiu Po Wang6
Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan1, Department of Integrated Diagnostics & Therapeutics, National Taiwan University Hospital, Taipei City, Taiwan2, Department of Gastroenterology, Biomedical Park Branch, National Taiwan University Hospital, Hsinchu County, Taiwan3, Department of Gastroenterology, Taitung Mackay Memorial Hospital, Taitung County, Taiwan4, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tri-service General Hospital, National Defense Medical Center, Taipei City, Taiwan5, Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan6
Background : EUS-PDD emerges as a solution for patients with pancreatic duct obstruction (PO) experiencing difficulties with retrograde access and surgical altered anatomy. However, it poses significant technical challenges for interventional endoscopists. This research reviewed the efficacy and outcomes of EUS-PPD in Taiwan.
Methods : This is a multi-center, retrospective study of patients receiving EUS-PDD between January 2018 and January 2024 at 5 centers in Taiwan.
Results : In total, 36 patients (75% male; mean age, 56 years) were included with 28 (78%) in EUS-guided pancreatogastrostomy (EUS-PG) and 8 (22%) in EUS-guided antegrade stenting (EUS-AS). Two-thirds of the PO were related to benign diseases. Technical and clinical success rates were 89% (25/28) and 86% (24/28) in EUS-PG group, compared with 75% (6/8) in EUS-AS group for both outcomes (P=0.303, 0.473). Shorter procedure time was recorded in the EUS-PG group (54.3 vs 79.6 mins, P=0.02). Dedicated stents and stents in larger diameter seemed to have lower risks of recurrent pancreatic obstruction (OR 0.6, 0.3) but without statistically difference (P=0.097, 0.096). In Kaplan-Meier survival curve, stent diameter≧7Fr provides significantly longer time to RPO compared with diameter≦5Fr (P=0.027). Application of dedicated plastic stent appeared to have similar results, though without statistically difference (P=0.07). 15 (42%) complications, mostly stent migration (11/36), were more commonly seen in patient using stents with smaller diameter.
Conclusions : EUS-PDD is feasible with adequate efficacy. No difference in clinical success and complication between EUS-PG and EUS-AS group. Larger stent provides longer time to RPO and less migration.
Methods : This is a multi-center, retrospective study of patients receiving EUS-PDD between January 2018 and January 2024 at 5 centers in Taiwan.
Results : In total, 36 patients (75% male; mean age, 56 years) were included with 28 (78%) in EUS-guided pancreatogastrostomy (EUS-PG) and 8 (22%) in EUS-guided antegrade stenting (EUS-AS). Two-thirds of the PO were related to benign diseases. Technical and clinical success rates were 89% (25/28) and 86% (24/28) in EUS-PG group, compared with 75% (6/8) in EUS-AS group for both outcomes (P=0.303, 0.473). Shorter procedure time was recorded in the EUS-PG group (54.3 vs 79.6 mins, P=0.02). Dedicated stents and stents in larger diameter seemed to have lower risks of recurrent pancreatic obstruction (OR 0.6, 0.3) but without statistically difference (P=0.097, 0.096). In Kaplan-Meier survival curve, stent diameter≧7Fr provides significantly longer time to RPO compared with diameter≦5Fr (P=0.027). Application of dedicated plastic stent appeared to have similar results, though without statistically difference (P=0.07). 15 (42%) complications, mostly stent migration (11/36), were more commonly seen in patient using stents with smaller diameter.
Conclusions : EUS-PDD is feasible with adequate efficacy. No difference in clinical success and complication between EUS-PG and EUS-AS group. Larger stent provides longer time to RPO and less migration.
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E-poster
E-Session 03/21 ALL DAY