Comparison Of The Effects Of Endoscopic Ultrasonagraphy Guided Drainage And Surgery Treatment On Pancreatic Fluid Collections

AIM:To compare the safety,efficacy,and cost of EUS(endoscopic ultrasonagraphy)guided drainage and surgical treatment on patients with pancreatic fluid collections,providing a reference for clinicians to decide an effective treatment plan.METHODS:This study used a retrospective study to collect clinical data of patients who suffered from pancreatic fluid collections and got diagnosed at the third affiliated hospital of Suzhou University from January 2012 to October 2019.Patients are screened according to the inclusion criteria and exclusion criteria.They received EUS guided drainage(including transmural drainage,and necrotic tissue debridement)or surgery.Statistical methods were used to analyze the technical success rate,symptom remission rate,image remission rate,complications,recurrence rate,hospitalization time and hospitalization cost of digestive endoscopy and surgical treatment.The clinical outcomes of the gastrointestinal endoscopy and surgical groups,as well as the clinical outcomes of the PPC and WON groups were compared.RESULTS:A total of 57 patients were included.32 patients(32/35,91.4%)in the EUS-guided endoscopic drainage were successfully operated,and 22 patients(22/22,100%)in the surgery group were successfully operated.Symptom remission rate(100%vs 90.9%),long-term imaging remission rate(90.1%vs 81.8%),recurrence rate(9.4%vs 9.1%)were not statistically significant between two groups(P>0.05).The short-term imaging remission rate of the ultrasound gastroscopy group was higher than that of the surgery group(100%vs 86.4%).The incidence of complications and hospitalization costs in the EUS-guided drainage group were significantly lower than those in the surgery group(12.5%vs 36.4%,P<0.05;25890.83±1943.31 vs 32092.92±1853.35,P<0.05).The short-term imaging remission rate of PPC group after endoscopic treatment was higher than that of surgery group(100%vs 80%).The days of hospitalization and hospitalization costs of ultrasound gastroscope treatment in the PPC group were significantly lower than those in the surgery group(13.8±1.57 vs 15.8±3.39,P<0.05;19679.27±5826.30 vs 33442.63±9811.98,P<0.001).CONCLUSION:EUS guided drainage is effective in the treatment of pancreatic fluid collections.The safety is higher than that of surgery,and it has less trauma,quicker recovery,and lower hospitalization costs.