Endoscopic Interventions for Treatment of Pancreatic Ascites- Six Years Single Center Experience

Aims We aimed to retrospectively analyze the data on all patients, admitted in our unit, with clinically significant pancreatic ascites over a six-year period.

Methods All patients with clinically significant pancreatic ascites for at least 2 weeks, hospitalized in our unit were included. All had paracentesis performed and ascitic fluid analysis demonstrated high protein-, amylase- and lipase- levels. In all patients endoscopic therapy was attempted and analyzed in terms of technical success, clinical success, complications, ascites resolution and recurrence.

Results Between 2014 and 2020 20 patients with pancreatic ascites were admitted in our unit. 15 of them had chronic pancreatitis. Ascites was a complication of severe acute pancreatitis in the late phase in 2. One patient had pancreatic trauma, one patient developed ascites after surgical biopsy of the pancreas, in one case pancreatic ascites developed after EUS- fine needle biopsy of a pancreatic head mass. Endoscopic interventions were technically successful in 19/20 patients. Pancreatic sphincterotomy followed by stenting of the main pancreatic duct was performed in 13 patients, pancreatic sphincterotomy alone in one, EUS guided drainage of peripancreatic fluid collection alone in one patient, combination of transpapillary stenting and EUS-guided transmural drainage in 2 patients, combination of EUS-guided transgastric drainage of peripancreatic fluid collection and EUS-guided pancreaticogastrostomy in one patient. Only one patient developed complication- sepsis due to infection of residual fluid collections, resolved with antibiotic therapy. Complete resolution of ascites occurred in all patients after successful endoscopic procedure. No recurrence was detected after a median follow up of 1 year (between 3 months and 4 years). No patient died.

Conclusions Endoscopic therapy is highly effective and safe in patients with pancreatic ascites. Depending on the clinical scenario, various combinations of different endoscopic modalities improve the outcome without increasing the rate of adverse events.

Citation: Karagyozov P, Mitova V, Tishkov I et al. OP171 ENDOSCOPIC INTERVENTIONS FOR TREATMENT OF PANCREATIC ASCITES- SIX YEARS SINGLE CENTER EXPERIENCE. Endoscopy 2021; 53: S70.

 

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Artikel online veröffentlicht:
19. März 2021