EFFICACY AND SAFETY OF A SELF-ASSEMBLING PEPTIDE HAEMOSTATIC GEL IN THE TREATMENT OF BLEEDING IN EUS-GUIDED DRAINAGE AND DIRECT ENDOSCOPIC NECROSECTOMY OF PANCREATIC FLUID COLLECTIONS

Abstract

Background and study aim: EUS-guided drainage and direct endoscopic necrosectomy (DEN) are primary treatment modalities for symptomatic pseudocysts and walled-off pancreatic necrosis (WOPN). Bleeding is a serious adverse event associated with drainage, also due to lack of effective endoscopic haemostatic techniques. Purastat demonstrated excellent results to manage gastrointestinal bleeding. Our aim was to evaluate the efficacy and safety of this haemostatic gel in managing bleeding secondary to EUS-guided drainage and DEN of pancreatic fluid collections (PFCs).

Patients and methods: In this multicenter, retrospective, observational study 27 patients underwent Purastat treatment because of active bleeding during or after PFCs EUS-guided drainage or WOPN DEN sessions between 2017 and 2024.

Results: 38 bleeding episodes were recorded. The bleeding type was oozing in 36 cases and spurting in 2 cases. Purastat was successfully applied in 100% of patients and achieved successful haemostasis in 96.5% of cases.

Conclusions: This novel haemostatic gel is a safe andeffectiveto manage oozing bleedings related to PFCs EUS-guided drainage or DEN.

Keywords: EUS-guided drainage; Purastat; bleeding; pancreatic fluid collection.