# The risk factors of bleeding after EUS-guided transmural drainage of pancreatic fluid collections: a single-center experience in China

## TL;DR

This study identifies cyst size as a key risk factor for bleeding after a procedure to drain pancreatic fluid collections using endoscopic ultrasound guidance.

## Contribution

The study identifies cyst size as an independent risk factor for post-procedural bleeding in EUS-guided transmural drainage.

## Key findings

- 14 out of 181 patients (7.7%) experienced bleeding after the procedure.
- Cyst size was found to be an independent risk factor for postoperative bleeding (OR, 2.722; 95%CI, 1.327–5.587).
- All bleeding cases were successfully managed with conservative or interventional treatments.

## Abstract

Endoscopic ultrasonography (EUS) guided transmural drainage has become a first-line treatment for peripancreatic fluid collections (PFCs). Post-procedure bleeding may lead to severe clinical outcomes.

The purpose of this study was to explore the patient-related and surgery-related factors associated with post-EUS drainage bleeding.

This is an observational cohort study. A total of 181 patients who underwent EUS drainage at our center between June 2019 and May 2024 were enrolled analyzed in the study. Postoperative bleeding complications were observed, and patient and operation-related data were collected. Univariate and multifactorial logistics regression were performed for the risk factors that may affect postoperative bleeding. Determine the risk factors influencing bleeding after EUS drainage.

We achieved a 100% technical success rate. A total of 14 cases (7.7%) of bleeding occurred. All bleeding patients were successfully treated by conservative, endoscopic, interventional and other treatments. Logistic regression analysis showed that cyst size was an independent risk factor for bleeding after EUS-guided transmural drainage (P = 0.006; OR, 2.722; 95%CI, 1.327–5.587).

The cyst size was an independent risk factor for bleeding after PFC drainage. Slowing the rate of decline in intracystic pressure may reduce the risk of bleeding.