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Research Article
Yin Zhu
First Affiliated Hospital of Nanchang University
Corresponding Author
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This work is licensed under a CC BY 4.0 License. Read Full License
Background
To investigate the association between features of necrotic collections on endoscopic ultrasound (EUS) and outcomes of the endoscopic transmural step-up approach.
Methods
This was a retrospective cohort study analyzing patients with necrotic collections underwent endoscopic transmural step-up approach. According to the amount of solid necrotic debris quantified as a percentage of the total collection size, participants were divided into three groups: <30% (group 1), 30%-50% (group 2), and >50% (group 3).
Results
Out of a total of 134 patients, the mean necrotic collection size was 8.5 (7.0, 10.0) cm, with <30% (group 1), 30%-50% (group 2) and >50% (group 3) solid debris present in 52, 59, and 23 patients, respectively. Patients with more solid necrotic debris needed more sessions of necrosectomy (group 1, 1 (0, 1) time vs. group 2, 1 (1, 2) time vs. group 3, 2 (2, 3) times, P<0.001), more likely experienced stent occlusion (group 1, 9.6% vs. group 2, 16.9% vs. group 3, 34.8%; P<0.05), and had a longer hospital stay (group 1, 25.5 (17.3, 44.0) days vs. group 2, 28.0 (19.0, 41.0) days vs. group 3, 40.0 (30.0, 58.0) days; P<0.05). Procalcitonin (OR, 6.14; 95% CI, 1.40-26.94; P<0.05) and any organ failure (OR, 11.51; 95% CI, 2.42-54.78; P<0.01) were independently associated with clinical failure of the endoscopic transmural step-up approach.
Conclusions
More solid debris on EUS predicted more sessions of necrosectomy, stent occlusion, and hospital stay. Procalcitonin and organ failure are risk factors for clinical failure of the endoscopic transmural step-up approach.
Keywords
endoscopic ultrasound, acute pancreatitis, acute necrotic collection, walled-off necrosis
Figure 1
Figure 2
No competing interests reported.
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View the published article at Journal of Digestive Diseases.
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A new preprint design is coming!
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This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research Article
Yin Zhu
First Affiliated Hospital of Nanchang University
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
View the published article at Journal of Digestive Diseases.
Version 1
Posted 04 Jun, 2021
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Gastroenterology & Hepatology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at Journal of Digestive Diseases.
Background
To investigate the association between features of necrotic collections on endoscopic ultrasound (EUS) and outcomes of the endoscopic transmural step-up approach.
Methods
This was a retrospective cohort study analyzing patients with necrotic collections underwent endoscopic transmural step-up approach. According to the amount of solid necrotic debris quantified as a percentage of the total collection size, participants were divided into three groups: <30% (group 1), 30%-50% (group 2), and >50% (group 3).
Results
Out of a total of 134 patients, the mean necrotic collection size was 8.5 (7.0, 10.0) cm, with <30% (group 1), 30%-50% (group 2) and >50% (group 3) solid debris present in 52, 59, and 23 patients, respectively. Patients with more solid necrotic debris needed more sessions of necrosectomy (group 1, 1 (0, 1) time vs. group 2, 1 (1, 2) time vs. group 3, 2 (2, 3) times, P<0.001), more likely experienced stent occlusion (group 1, 9.6% vs. group 2, 16.9% vs. group 3, 34.8%; P<0.05), and had a longer hospital stay (group 1, 25.5 (17.3, 44.0) days vs. group 2, 28.0 (19.0, 41.0) days vs. group 3, 40.0 (30.0, 58.0) days; P<0.05). Procalcitonin (OR, 6.14; 95% CI, 1.40-26.94; P<0.05) and any organ failure (OR, 11.51; 95% CI, 2.42-54.78; P<0.01) were independently associated with clinical failure of the endoscopic transmural step-up approach.
Conclusions
More solid debris on EUS predicted more sessions of necrosectomy, stent occlusion, and hospital stay. Procalcitonin and organ failure are risk factors for clinical failure of the endoscopic transmural step-up approach.
Figure 1
Figure 2
No competing interests reported.
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