Laique S, Franco MC, Stevens T, Bhatt A, Vargo JJ, Chahal P. Clinical outcomes of endoscopic management of pancreatic fluid collections in cirrhotics vs non-cirrhotics: A comparative study. World J Gastrointest Endosc 2019; 11(6): 403-412 [PMID: 31236193 DOI: 10.4253/wjge.v11.i6.403]
Corresponding Author of This Article
Prabhleen Chahal, MD, Attending Doctor, Staff Physician, Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Ave, A30, Cleveland, OH 44195, United States. chahalp@ccf.org
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Jun 16, 2019; 11(6): 403-412 Published online Jun 16, 2019. doi: 10.4253/wjge.v11.i6.403
Clinical outcomes of endoscopic management of pancreatic fluid collections in cirrhotics vs non-cirrhotics: A comparative study
Sobia Laique, Matheus C Franco, Tyler Stevens, Amit Bhatt, John J Vargo, Prabhleen Chahal
Sobia Laique, Internal Medicine, Cleveland Clinic, Cleveland, OH 44195, United States
Matheus C Franco, Tyler Stevens, Amit Bhatt, John J Vargo, Prabhleen Chahal, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH 44195, United States
Author contributions: Laique S contributed to study design, acquisition of data, analysis and interpretation of data, drafting of the manuscript, critical revision of the manuscript for important intellectual content; Franco MC contributed to study concept and design, acquisition of data, drafting of the manuscript, critical revision of the manuscript for important intellectual content; Stevens T, Bhatt A and Vargo JJ contributed to critical revision of the manuscript for important intellectual content; Chahal P contributed to study supervision, study concept and design, critical revision of the manuscript for important intellectual content.
Institutional review board statement: The study was approved by the Cleveland Clinic Institutional Review Board.
Conflict-of-interest statement: Nothing to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Prabhleen Chahal, MD, Attending Doctor, Staff Physician, Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Ave, A30, Cleveland, OH 44195, United States. chahalp@ccf.org
Telephone: +1-216-4446521 Fax: +1-216-4446284
Received: March 2, 2019 Peer-review started: March 3, 2019 First decision: March 20, 2019 Revised: May 16, 2019 Accepted: May 23, 2019 Article in press: May 23, 2019 Published online: June 16, 2019 Processing time: 104 Days and 13.8 Hours
Core Tip
Core tip: Endoscopic ultrasound-guided management of pancreatic fluid collections (PFCs) using self-expandable metal stents has a high technical and clinical success rate. However, their use in cirrhotics has not yet been studied. We conducted the first comparative study to assess the safety and outcomes of endoscopic management of symptomatic PFCs in cirrhotics vs non-cirrhotics. Despite a 100% technical success rate, clinical success was achieved in only 60% of cirrhotic patients with a procedure-related adverse event rate of 60%. Moreover, fatal adverse events were statistically more common in cirrhotics compared with non-cirrhotics (0% vs 40%; P = 0.023). Thus, given the high morbidity and mortality as evidenced by our cohort, caution must be exercised in this group. Larger, multicenter studies are warranted to further characterize the risk profile and outcomes in these patients.
