Korean J Pancreas Biliary Tract.  2018 Jan;23(1):24-31. 10.15279/kpba.2017.23.1.24.

Endoscopic Ultrasound-guided Pancreatic Pseudocyst Drainage without Fluoroscopy

Affiliations
  • 1Department of Internal Medicine, Pusan National University School of Medicine, and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea. doc0224@pusan.ac.kr

Abstract

BACKGROUND
/AIMS
Pancreatic pseudocyst is a common complication of acute and chronic pancreatitis. Endoscopy ultrasound (EUS)-guided drainage includes multiple steps and requires many resources such as a linear echoendoscope and a fluoroscopy room, which may not be available at all medical centers. We aimed to evaluate the efficacy and safety of EUS-guided pancreatic pseudocyst drainage without fluoroscopy.
METHODS
This retrospective study analyzed 10 patients who had undergone EUS-guided transmural drainage of pancreatic pseudocyst without use of fluoroscopy at the Pusan National University Hospital between January 2009 and December 2016. Drainage was performed via a transgastric approach and one or two 7 Fr double-pigtail stents were inserted.
RESULTS
The technical success rate was 100% and the clinical success rate was 80%. In two patients, clinical success was not achieved and additional percutaneous catheter drainage was done. Therefore, pseudocysts in all the patients were treated successfully without surgical drainage. However, there were three adverse events in three patients: bleeding, infection, and stent migration in each respective patient. During the median follow-up period of 36.5 months, there was no recurrence of pseudocysts in any of the patients.
CONCLUSIONS
EUS-guided transmural drainage of pseudocyst drainage without use of fluoroscopy is a technically feasible, safe, and effective procedure for the treatment of pancreatic pseudocyst.

Keyword

Pancreas; Pancreatic pseudocyst; Endosonography; Fluoroscopy
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