Tiellemans, S. (Sanne) (2019) Clinical and microbiologic evaluation of endoscopic drainage of peripancreatic fluid collections after pancreatitis: a single centre case series report. thesis, Medicine.
Full text available on request.Abstract
Background: Pancreatitis is a polyetiological non-infectious inflammation of the pancreas, whereupon peripancreatic fluid collections (PFC) may occur. Infection of these fluid collections is a potentially life-threatening condition and may need an interventional drainage strategy. Endoscopic ultrasound (EUS) guided drainage is a minimally invasive modality for the drainage of peripancreatic fluid collections. This study evaluated clinical and microbiologic results of EUS drained patients with pancreatitis and PFC’s. Method: In this retrospective study, we included adult patients who underwent an EUS-guided transluminal drainage of PFC after acute or acute-on-chronic pancreatitis, from March 2006 until September 2018 in Máxima Medical Centre (MMC) in the Netherlands. The treatment success, hospital stay, complications, microbiologic culture of PFC’s, and the quality of life (QOL) were analysed. Results: In 72 patients (48M, 24F), 82 drainages were performed. After one year, 72% of the drainages were successful. The median hospital stay was 12 days. In 25 (32%) drainages a severe complication was registered and in 13 (17%) a minor complication. Two patients (2,8%) died during illness. 73% (46 out of 73) of the aspirated cultures from the PFC, showed colonization. 35 (76%) showed polymicrobiologic growth; Gram-positive bacteria were more prevalent than Gram-negative bacteria and Candida species (40%, 35% and 25% respectively). QOL reaches general population results. Conclusion: EUS-guided drainage was highly successful in patients with (infected) PFC after pancreatitis. We registered moderate morbidity and low mortality rates. Long-term quality of life reaches general population results. The PFC cultures showed polymicrobial growth with one fourth Candida species. Direct microbiologic culturing of PFC’s is relevant to optimize an individual antimicrobial strategy.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Faculty supervisor: and Dullemen, Dr. H.M. |
| Supervisor name: | Supervisor: and Straathof, Dr. J.W.A. and Máxima Medisch Centrum, Veldhoven and Department of Gastroenterology |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:51 |
| Last Modified: | 25 Jun 2020 10:51 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1183 |
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