A Comparison of Percutaneous versus Endoscopic Drainage in the Management of Pancreatic Fluid Collections: A Prospective Cohort Study.

INTRODUCTION: Currently, endoscopic drainage (ED) and percutaneous drainage (PD) are both widely used effective interventions in the management of patients with symptomatic pancreatic fluid collections (PFCs). This study aimed to compare the clinical effectiveness and safety of ED to those of PD in the treatment of PFCs.

MATERIAL/METHODS: A prospective cohort study of PFC patients who underwent ED or PD was conducted between January 2009 and December 2017. In this study, the initial success rate, adverse events, intervention, requirement of surgical treatment, hospital mortality within 30 days, length of hospital stay and expenses during hospitalization were monitored, and a follow-up investigation of treatment outcome was conducted. Long-term recovery, recurrence and mortality were determined according to telephone follow-up.

RESULTS: In total, 129 patients were included in the study; 62 patients underwent ED, and 67 patients underwent PD during the 8-year study period. Initial treatment success was considerably higher in patients whose PFCs were managed by ED than in patients whose PFCs were managed by PD (94.9% vs 65.0%, p=0.003). The rate of procedural adverse events, reintervention, length of hospitalization and expense were all higher in the PD group than in the ED group, but the long-term recovery rate and requirement of surgical intervention were not clearly different between patients who underwent the two treatment measures.

CONCLUSION: ED of symptomatic PFCs was associated with higher rates of initial treatment success, lower rates of reintervention and adverse events and a shorter hospital stay than PD of symptomatic PFCs.