ArticleSurgical endoscopy2023
Computed tomography imaging-based predictors of the need for a step-up approach after initial endoscopic ultrasound-guided transmural drainage for pancreatic fluid collections.
Article in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 12 citations in OpenAlex.
- Article
- Guidelines for endoscopic treatment of postinflammatory pancreatic and peripancreatic fluid collections. Recommendations of the Endoscopic Surgery Section of the Association of Polish Surgeons, the Endoscopy Section of the Polish Society of Gastroenterology, the Polish Pancreatic Club, the Laparoscopic and Robotic Surgery Section of the Association of Polish Surgeons, and the Pancreatic Surgery Section of the Association of Polish Surgeons; formulated by an expert panel led by Prof. Mateusz Jagielski, MD, PhD.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2025Review
- Comparative outcome of metal versus plastic stents for the management of walled-off pancreatic necrosis - An updated meta-analysis of randomised studies.Journal of minimal access surgery · 2025Article
- Infected pancreatic necrosis-Current trends in management.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2024Review
- Time to think prime times for treatment of necrotizing pancreatitis: Pendulum conundrum.Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society · 2023Review
- Endoscopic ultrasound drainage of pancreatic fluid collections: do we know enough about the best approach?Therapeutic advances in gastroenterology · 2023Review
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Authors and funding
17 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA step-up approach is recommended as a new treatment algorithm for pancreatic fluid collections (PFCs). However, determining which patients with PFCs require a step-up approach after endoscopic ultrasound-guided transmural drainage (EUS-TD) is unclear. If the need for a step-up approach could be predicted, it could be performed early for relevant patients. We aimed to identify PFC-related predictive factors for a step-up approach after EUS-TD.
methodsThis retrospective cohort study included consecutive patients who had undergone EUS-TD for PFCs from January 2008 to May 2020. Multivariable logistic regression analyses were performed to investigate PFC factors related to requiring a step-up approach. A step-up approach was performed for patients who did not respond clinically to EUS-TD.
resultsWe enrolled 81 patients, of whom 25 (30.9%) required a step-up approach. In multivariate logistic regression analysis, the pre-EUS-TD number of PFC-occupied regions ≥ 3 (multivariate odds ratio [OR] 16.2, 95% confidence interval [CI] 2.68-97.6, P = 0.002), the post-EUS-TD PFC-remaining percentage ≥ 35% (multivariate OR 19.9, 95% CI 2.91-136.1, P = 0.002), and a positive sponge sign, which is a distinctive computed tomography finding in the early stage after EUS-TD (multivariate OR 6.26, 95% CI 1.33-29.3, P = 0.020), were independent predictive factors associated with requiring a step-up approach for PFCs.
conclusionPre-EUS-TD PFC-occupied regions, post-EUS-TD PFC-remaining percentage, and a positive sponge sign were predictors of the need for a step-up approach. Patients with PFC with these findings should be offered a step-up approach whereas conservative treatment is recommended for patients without these findings. CLINICAL REGISTRATION NUMBER: UMIN 000030898.
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