Saudi Journal of Gastroenterology
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ORIGINAL ARTICLE
Year : 2021  |  Volume : 27  |  Issue : 5  |  Page : 275-282

Usefulness of Routine Plain CT the Day After an Interventional EUS Procedure


1 Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo; Department of Gastroenterology, Obihiro Daiichi Hospital, Hokkaido, Japan
2 Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo, Japan

Correspondence Address:
Dr. Hiroyuki Isayama
Department of Gastroenterology, Graduate School of Medicine, Juntendo University, 3-1-3 Hongo, Bunkyo-ku, Tokyo, 113-8421
Japan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sjg.sjg_81_21

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Background: Interventional endoscopic ultrasound-guided procedures (I-EUS) are widely accepted as salvage procedures in ERCP-failed cases, and to drain fluid collected in the abdominal cavity. Although I-EUS has a relatively high incidence of complications and is severe/fatal in some cases, no follow-up strategy has been established. In our institution, plain computed tomography (P-CT) is performed routinely the day after I-EUS. In this study, we evaluated the usefulness of routine P-CT the day after I-EUS, as a follow-up method, and propose an algorithm. Methods: We retrospectively reviewed 81 patients who underwent I-EUS and evaluated the usefulness of P-CT, abdominal X-ray, laboratory data, and symptoms as a follow-up method. An adverse event (AE) was defined as an event requiring any treatment. Results: Technical success, clinical success, and AE rates were 96.3%, 90.1%, and 18.9%, respectively. In total, 30 patients had abnormal findings among the follow-up methods: 6 cases underwent additional procedures, 8 underwent medical treatments, and 16 were observed. The sensitivity, specificity, and accuracy for detecting AEs were assessed based on P-CT (85.7%, 100%, and 97.5%), X-ray (7.1%, 100%, and 83.5%), laboratory data (71.4%, 83.0%, and 81.0%), and symptoms (92.9%, 86.2%, and 87.3%). The sensitivity and accuracy of the latter two items were as high as those for X-ray, but specificity was lower than those for X-ray and P-CT. Conclusions: Routine P-CT the day after I-EUS was useful for detecting complications and deciding to perform an invasive salvage procedure. Symptoms and laboratory data were useful to supplement routine P-CT.


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