Background/Aims: Gastric acid secretion is suspected to be a pivotal contributor to the pathogenesis of functional dyspepsia. The present study investigates the potential association of the gastric acid secretion estimated by measuring serum pepsinogen with therapeutic responsiveness to the prokinetic drug acotiamide. Methods: Dyspeptic patients consulting participating clinics from October 2017 to March 2019 were prospectively enrolled in the study. The dyspeptic symptoms were classified into postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS). Gastric acid secretion levels were estimated by the Helicobacter pylori infection status and serum pepsinogen using established criteria and classified into hypo-, normo-, and hyper-secretion. Each patient was then administered 100 mg acotiamide thrice daily for 4 weeks, and the response rate to the treatment was evaluated using the overall treatment efficacy scale. Results: Of the 86 enrolled patients, 56 (65.1%) and 26 (30.2%) were classified into PDS and EPS, respectively. The estimated gastric acid secretion was not significantly different between PDS and EPS. The response rates were 66.0% for PDS and 73.1% for EPS, showing no significant difference. While the response rates were stable, ranging from 61.0% to 75.0% regardless of the estimated gastric acid secretion level among subjects with PDF, the rates were significantly lower in hyper-secretors than in non-hyper-secretors among subjects with EPS (42.0% vs 83.0%, P = 0.046). Conclusion Although acotiamide is effective for treating EPS as well as PDS overall, the efficacy is somewhat limited in EPS with gastric acid hypersecretion, with gastric acid suppressants, such as proton pump inhibitors, being more suitable.

Background: Endoscopic ultrasound-guided drainage (EUSD) is an effective treatment for postoperative pancreatic fluid collections (POPFCs); however, standards regarding stents used for EUSD have not been established. This study analyzed the outcomes of EUSD of POPFCs at our hospital and examined the safety and effectiveness of plastic stents/tubes. Methods: This retrospective, single-center study focused on EUSD of POPFCs performed at our hospital. We examined the rates of technical success, clinical success, adverse events, and recurrence. Results: Twenty-seven patients were included in this study. The initial drainage methods comprised one nasocystic plastic tube (NPT) and one double-pigtail plastic stent (DPS) for 19 (70.4%) patients, two DPS for four (14.8%) patients, one NPT for three (11.1%) patients, and one lumen-apposing metal stent for one (3.7%) patient. The technical success and clinical success rates were both 100%. Fourteen of the 19 patients with one NPT and one DPS improved, but five patients required additional interventions and improved with fistula site dilation. Although recurrence occurred in one patient, improvement was achieved with second EUSD. Early adverse events comprised one case of bleeding for which hemostasis was achieved by performing coil embolization. Late adverse events comprised three cases of DPS migration; however, no additional intervention was required. Conclusion The use of plastic tubes/stents is safe and effective for EUSD of POPFCs.

Background: Endoscopic ultrasound-guided drainage (EUSD) is an effective treatment for postoperative pancreatic fluid collections (POPFCs); however, standards regarding stents used for EUSD have not been established. This study analyzed the outcomes of EUSD of POPFCs at our hospital and examined the safety and effectiveness of plastic stents/tubes. Methods: This retrospective, single-center study focused on EUSD of POPFCs performed at our hospital. We examined the rates of technical success, clinical success, adverse events, and recurrence. Results: Twenty-seven patients were included in this study. The initial drainage methods comprised one nasocystic plastic tube (NPT) and one double-pigtail plastic stent (DPS) for 19 (70.4%) patients, two DPS for four (14.8%) patients, one NPT for three (11.1%) patients, and one lumen-apposing metal stent for one (3.7%) patient. The technical success and clinical success rates were both 100%. Fourteen of the 19 patients with one NPT and one DPS improved, but five patients required additional interventions and improved with fistula site dilation. Although recurrence occurred in one patient, improvement was achieved with second EUSD. Early adverse events comprised one case of bleeding for which hemostasis was achieved by performing coil embolization. Late adverse events comprised three cases of DPS migration; however, no additional intervention was required. Conclusion The use of plastic tubes/stents is safe and effective for EUSD of POPFCs.

Background: Endoscopic ultrasound-guided drainage (EUSD) is an effective treatment for postoperative pancreatic fluid collections (POPFCs); however, standards regarding stents used for EUSD have not been established. This study analyzed the outcomes of EUSD of POPFCs at our hospital and examined the safety and effectiveness of plastic stents/tubes. Methods: This retrospective, single-center study focused on EUSD of POPFCs performed at our hospital. We examined the rates of technical success, clinical success, adverse events, and recurrence. Results: Twenty-seven patients were included in this study. The initial drainage methods comprised one nasocystic plastic tube (NPT) and one double-pigtail plastic stent (DPS) for 19 (70.4%) patients, two DPS for four (14.8%) patients, one NPT for three (11.1%) patients, and one lumen-apposing metal stent for one (3.7%) patient. The technical success and clinical success rates were both 100%. Fourteen of the 19 patients with one NPT and one DPS improved, but five patients required additional interventions and improved with fistula site dilation. Although recurrence occurred in one patient, improvement was achieved with second EUSD. Early adverse events comprised one case of bleeding for which hemostasis was achieved by performing coil embolization. Late adverse events comprised three cases of DPS migration; however, no additional intervention was required. Conclusion The use of plastic tubes/stents is safe and effective for EUSD of POPFCs.