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Table 2 Synopsis of basic endoscopic vacuum therapy (EVT) data

From: Management of post-operative pancreatic fistulas following Longmire–Traverso pylorus-preserving pancreatoduodenectomy by endoscopic vacuum-assisted closure therapy

Patient no

POPF grade (ISGPS A/B/C)

POPF diagnosis (days post PPPD)

Initial PGD size (mm)

Begin EVT (days post PPPD)

Initial EVT system (film/sponge)

No. of EVT film/sponge exchanges

Duration of continuous EVT (days)

Additional endoscopic therapy

Initial EVT pressure (mmHg)

Successful PGD closure at the end of EVT

Outcome

1

B

15

8

24

Sponge

6

29

PGD dilation (10 mm balloon, single session) and DEN

125

Yes

Died 13 months post PPPD from relapse of cholangiocarcinoma

2

B

11

10

12

Film

1

8

 

125

Yes

Alive until follow-up

3

B

3

8

13

Sponge (later film)

2

8

 

125

Yes

Alive until follow-up

4

C

28

4

33

Film

2

11

 

125

Yes

Alive until follow-up

5

B

22

8

26

Film

2

11

 

125

Yes

Alive until follow-up

6

B

2

12

2

Sponge

4

14

 

100 (later increased to 125)

Yes

Alive until follow-up

7

B

17

15

18 (2nd cycle: 63)

Sponge

6 (2nd cycle: 3)

23 (2nd cycle: 15)

DEN and 22 days EVT-free interval between 1st and 2nd EVT cycle with transgastral double pig-tailed drainage of wound cavity

125 (later increased to 150)

Yes (after 2nd cycle)

Died 5 months post PPPD from pneumoseptic and uroseptic shock

8

C

6

2

12

Film

1

6

 

100

No

Died 1 month post PPPD from hemorrhagic shock before proof of effectiveness of EVT

  1. DEN (direct endoscopic necrosectomy), ISGPS (International Study Group on Pancreatic Surgery), PGD (pancreatogastric dehiscence), POPF (post-operative pancreatic fistula), PPPD (pylorus-preserving pancreatoduodenectomy)