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Multivariate analysis of the factors affecting the prognosis of walled-off pancreatic necrosis after endoscopic ultrasound-guided drainage

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Abstract

Background and aims

Endoscopic ultrasound (EUS)-guided drainage has become the treatment of choice for walled-off pancreatic necrosis (WOPN). However, no consensus exists on the most significant patient- and procedure-related factors that affect prognosis. The aim of the study is to investigate the correlation between patient- and procedure-related factors and post-procedure complications after EUS-guided drainage.

Methods

A retrospective analysis of the clinical characteristics of patients with WOPN who underwent EUS-guided drainage at our endoscopy center between November 2011 and August 2017 was performed. Chi-square analysis and binary logistic regression statistical methods were used to analyze the correlation between influencing factors and prognosis.

Results

A total of 85 patients (male/female, 50/35) with WOPN were included in the study. The average age was 44.95 years. The cyst diameter was 10.58 ± 4.78 cm. Multivariate analysis showed that WOPN with higher solid content (> 30%) increased the probability of endoscopic necrosectomy (OR 6.798; 95% CI 1.423, 32.470; p = 0.016). The use of a metal stent increased the probability of endoscopic necrosectomy (OR 3.503; 95% CI 1.251, 9.810; p = 0.017) and the length of hospitalization (OR 3.315; 95% CI 1.192, 9.215; p = 0.022). Female patients had a higher probability of requiring endoscopic necrosectomy (OR 2.683; 95% CI 1.027, 7.007; p = 0.044) and prolonged hospitalization (OR 2.675; 95% CI 1.065, 6.721; p = 0.036).

Conclusion

The solid content of WOPN, type of stent, and sex of patients were associated with increased probability of endoscopic necrosectomy.

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Acknowledgements

This study was supported by the Natural Science Foundation of Liaoning Province (Grant No. MS0038) and Shengjing Free Researcher Project Foundation (Grant No. MF73). We thank all of the physicians who participated in this study.

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Authors and Affiliations

  1. Endoscopy Center, Shengjing Hospital of China Medical University, No. 36, Sanhao Street, Shenyang, 110004, Liaoning, China

    Jintao Guo, Bowen Duan, Siyu Sun, Sheng Wang, Xiang Liu, Nan Ge, Wen Liu, Shupeng Wang & Jinlong Hu

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  1. Jintao Guo
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Correspondence to Siyu Sun.

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Jintao Guo, Bowen Duan, Siyu Sun, Sheng Wang, Xiang Liu, Nan Ge, Wen Liu, Shupeng Wang, and Jinlong Hu declare that they have no conflicts of interest or financial ties to disclose.

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Guo, J., Duan, B., Sun, S. et al. Multivariate analysis of the factors affecting the prognosis of walled-off pancreatic necrosis after endoscopic ultrasound-guided drainage. Surg Endosc 34, 1177–1185 (2020). https://doi.org/10.1007/s00464-019-06870-3

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