Retrospective cohort study comparing endoscopic ultrasound‐guided and percutaneous drainage of upper abdominal abscesses

Abstract

Background and aims

EUS‐guided drainage (EUS‐D) has become the standard treatment for peripancreatic fluid collections. Its use in other intrabdominal abscesses has been reported, although there is limited evidence.

Patients and methods

We performed a single center retrospective cohort study comparing percutaneous drainage (PCD) and EUS‐D of upper abdominal abscesses between January 2012 and June 2017. Pancreatic fluid collections and liver transplant recipients were excluded. Primary endpoints were technical and clinical success rates.

Results

We included 18 EUS‐Ds (9 hepatic and 9 intraperitoneal abscesses) and 62 PCDs. There were no differences regarding age, sex and etiology. Size was larger in the PCD group (80 vs 65.5 mm, p=0.04) and perivesicular location was more frequent in the PCD group (24.2% vs 11.1%, p=0.003).

In the EUS‐D group, metal stents were deployed in 16 (89.9%) subjects (8 lumen apposing metal stents and 8 self‐expandable metal stents), coaxial double‐pigtail plastic stents in 6 (33.3%) and lavage/debridement was performed in 5 (27.8%).

There were no significant differences in technical success (EUS‐D: 88.9%, PCD: 96.8%, p=0.22) or clinical success (EUS‐D: 88.9%, PCD: 82.3%, p=0.50), with no relapses in the EUS‐D and 10 (16.1%) in the PCD group (p=0.11). There were 4 (22.2%) adverse events in the EUS‐D group, none of them severe, and 13 (21%) in the PTD group (p=0.91).

Conclusions

EUS‐D is an alternative to PCD in the treatment of upper abdominal abscesses, reaching similar success, relapse and adverse events rates.

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