Postoperative abdominal collections drainage: Percutaneous versus guided by endoscopic ultrasound

Background and Aim Postoperative fluid collections (POFC) have high mortality. Percutaneous drainage (PD) is the preferred treatment modality. Drainage guided by endoscopic ultrasound (EUS‐GD) represents a good alternative. The aim of the present study was to compare clinical success and complication rates of EUS‐GD versus PD. Methods Data collected prospectively were analyzed in a retrospective manner. Patients with POFC from October 2008 to November 2013 were included. All collections were drained percutaneously or by EUS‐GD. Results Sixty‐three procedures in 43 patients with POFC were analyzed; 13 patients were drained using EUS‐GD and 32 patients with PD. Two patients assigned initially to the PD group were reassigned to EUS‐GD. Surgery procedures most often related to the collections were intestinal reconnection, distal pancreatectomy, biliary‐digestive bypass, and exploratory laparotomy. Technical success (100% vs 91%; P = 0.25), clinical success (100% vs 84%; P = 0.13), recurrence (31% vs 25%; P = 0.69), hospital stay days (median 22 vs 27; P = 0.35), total costs (8328 ± 1600 USD vs 11 047 ± 1206 USD; P = 0.21), complications (0% vs 6%; P = 0.3), and mortality (8% vs 6%; P = 0.9) were each evaluated in the EUS‐GD and PD groups, respectively. In the PD group one death was related to the procedure. Conclusions EUS‐GD is as effective and safe as PD in patients with POFC. The advantage of not requiring external drainage and a trend to higher clinical success and lower total costs must be considered.