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The role of solid debris in endoscopic ultrasound‐guided drainage of walled‐off necrosis: A large cohort study
Author(s) -
Zhu Huiyun,
Xie Pei,
Wang Yuxin,
Jin Zhendong,
Li Zhaoshen,
Du Yiqi
Publication year - 2020
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.15086
Subject(s) - medicine , endoscopic ultrasound , confidence interval , odds ratio , stent , debris , adverse effect , surgery , magnetic resonance imaging , drainage , radiology , nuclear medicine , ecology , biology , oceanography , geology
Background and Aim The effect of solid debris on walled‐off necrosis (WON) drainage remains unknown. Our study evaluated the role of solid debris in endoscopic ultrasound (EUS)‐guided drainage of WON compared lumen‐apposing metal stent (LAMS) with double‐pigtail plastic stent (DPPS). Methods We retrospectively evaluated consecutive patients with WON who underwent EUS‐guided drainage in our endoscopic center over a 9‐year period. The amount of solid debris in WON was assessed with computed tomography or magnetic resonance imaging and EUS images. Results From 2011 to 2019, 84 WON patients were included. In WON with < 20% solid debris, the short‐term clinical success of LAMSs (96.8%) was significantly higher than DPPSs (66.7%) ( P = 0.03), and LAMSs were safer than DPPSs with less early adverse events ( P = 0.02) and late adverse events ( P = 0.03). On multivariable analysis, DPPS (odds ratio [OR], 0.16; 95% confidence interval [CI], 0.04–0.65; P = 0.01) and solid debris > 40% (OR, 0.11; 95% CI, 0.02–0.62; P = 0.01) were the predictors for failure of resolution of WON after adjusting for age and cyst size. The number of DPPSs used was significantly higher than LAMSs in managing WONs ( P < 0.001). Conclusion For WON with < 20% solid debris, LAMSs might superior to DPPSs in terms of efficacy and safety.