Short- and long-term results of endoscopic ultrasound-guided transmural drainage for pancreatic pseudocysts and walled-off necrosis

Table 1 Demographic and clinical characteristics of patients who underwent endoscopic ultrasound-guided transmural drainage n (%)

characteristics	Value
Age, yr
mean (SD)	54.7 (15.5)
Range	15-89
Median	56
Gender
Male	73 (70.9)
Female	30 (29.1)
Type of pancreatitis
Acute pancreatitis	46(44.6)
Chronic pancreatitis	38 (36.9)
Other	19 (18.4)
Etiology of PFC
Alcohol	51 (49.5)
Idiopathic	17 (16.5)
Gallstones	15 (14.5)
Trauma	6 (5.9)
Post-surgery (pancreatic fistula)	7 (6.8)
Post-ERCP	3 (2.9)
Pancreatic cancer	4 (3.9)
Category of PFC
WON	40 (38.8)
Pancreatic pseudocyst	11 (10.7)
Chronic pseudocyst	33 (32.0)
Others (cancer/trauma/fistula)	19 (18.5)
Main location of cavity
Head	19 (18.4)
Body or tail	84 (81.6)
Size of cavity, mm (long axis)
mean (SD)	104.4 (49.0)
Range	30-246
Median	100

EUS-GTD: Endoscopic ultrasound-guided transmural drainage; PFC: Pancreatic fluid collection; SD: Standard deviation; ERCP: Endoscopic retrograde cholangio-pancreatogram; WON: Walled-off pancreatic necrosis.

Table 2 Comparison of patient demographics and clinical characteristics in patients underwent endoscopic ultrasound-guided transmural drainage of walled-off necrosis n (%)

		Treatment success		P value
		Yes (n = 23)	No (n = 16)
Age, yr	Mean (SD)	57.8 (18.1)	55.8 (13.1)
	Range	15-85	30-83	0.484
Gender	Male	16 (69.6)	14 (87.5)	0.359
Etiology of pancreatitis	Alcohol	8 (34.8)	6 (37.5)	0.862
Body mass index	Mean (SD)	23.3 (5.5)	24.2 (3.6)	0.203
ASA classification ≥ 3	Yes	12 (52.2)	13 (81.2)	0.09
Pancreatic parenchymal necrosis ≥ 50%	Yes	2 (8.7)	9 (56.3)	0.004
Duration from onset of pancreatitis to drainage, wk	Mean (SD)	11.1 (7.8)	9.4 (10.9)
	Range	3.1-25.3	2.0-47.7	0.219
Size of cavity, mm (long axis)	Mean (SD)	109.9 (35.7)	156.9 (35.7)
	Range	70-246	66-207	< 0.001
Size of cavity ≥ 150 mm	Yes	2 (8.7)	11 (68.8)	< 0.001
PFC with infection	Yes	13 (56.5)	13 (81.3)	0.203
Follow-up durations, mo	Mean (SD)	26.9 (30.8)	28.1 (33.9)	0.808
	Range	0.7-133.5	1.3-128.3

EUS-GTD: Endoscopic ultrasound-guided transmural drainage; WON: Walled-off pancreatic necrosis; PFC: Pancreatic fluid collection; SD: Standard deviation.

Table 3 Multiple logistic regression analysis examining factors associated with treatment success for walled-off necrosis

Multiple logistic regression	OR	95%CI	P value
Pancreatic parenchymal necrosis (< 50% vs ≥ 50%)	17.0	1.9-150.7	0.011
Size of cavity (< 150 mm vs ≥ 150 mm)	27.9	3.4-227.7	0.002

Table 4 Treatment success rate of walled-off necrosis according to two parameters; pancreatic parenchymal necrosis and size of cavity

	Size of cavity < 150 mm	Size of cavity ≥ 150 mm
Pancreatic parenchymal necrosis < 50%	90.5% (19/21)	28.6% (2/7)
Pancreatic parenchymal necrosis ≥ 50%	40.0% (2/5)	0% (0/6)

Table 5 Pancreatic fluid collection recurrence in patients followed-up over 6 mo and confirmed internal stent removal after successful endoscopic ultrasound-guided transmural drainage (n = 75) n (%)

		Recurrence		P value
		Yes (n = 10)	No (n = 65)
Age, yr	Mean (SD)	54.4 (12.6)	55.1 (15.9)
	Range	37-79	15-89	0.719
Gender	Male	9 (90)	45 (69.2)	0.266
Type of pancreatitis	Chronic	6 (60)	22 (33.8)	0.162
Main location of cavity	Head	1 (10)	16 (24.6)	0.677
External drainage only	Yes	2 (20)	9 (13.8)	0.634
Duration of internal stent, days (n = 64)	Mean (SD)	194.9 (106.1)	243.2 (217.3)
	Range	86-399	21-1387	0.659
Spontaneous dislodgement of stent (n = 64)	Yes	4 (50)	17 (30.4)	0.421
Size of cavity, mm (long axis)	Mean (SD)	91.6 (38.0)	102.6 (49.3)
	Range	44-167	30-230	0.612
Amylase in cavity, IU/L (n = 57)	Mean (SD)	96930 (55599)	44719 (53790)
	Range	31380-188000	30-273700	0.011
	Median	83075	31200
PFC with infection	Yes	2 (20)	28 (43.1)	0.298

PFC: Pancreatic fluid collection; SD: Standard deviation; EUS-GTD: Endoscopic ultrasound-guided transmural drainage.