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. 2013 Oct;2(4):199-203.
doi: 10.4103/2303-9027.121245.

Endoscopic Ultrasound-guided Drainage of Pancreatic Pseudocysts: Medium-Term Assessment of Outcomes and Complications

Pui Yung Ng  1 , Ditlev Nytoft Rasmussen  2 , Peter Vilmann  3 , Hassem Hassan  3 , Victor Gheorman  4 , Daniela Burtea  4 , Valeriu Surlin  4 , Adrian Săftoiu  4
Affiliations

Endoscopic Ultrasound-guided Drainage of Pancreatic Pseudocysts: Medium-Term Assessment of Outcomes and Complications

Pui Yung Ng et al. Endosc Ultrasound. 2013 Oct.

Abstract

Objective: Endoscopic ultrasound (EUS)-guided drainage is a widely used treatment modality for pancreatic pseudocysts (PPC). However, data on the clinical outcome and complication rates are conflicting. Our study aims to evaluate the rates of technical success, treatment success and complications of EUS-guided PPC drainage in a medium-term follow-up of 45 weeks.

Materials and methods: A retrospective review was conducted for 55 patients with symptomatic PPC from December 2005 to August 2010 drained by EUS. Medium-term follow-up data were obtained by searching their medical history or by telephonic interview.

Results: A total of 61 procedures were performed. The symptoms that indicated drainage were abdominal pain (n = 43), vomiting (n = 7) and jaundice (n = 5). The procedure was technically successful in 57 of the 61 procedures (93%). The immediate complication rate was 5%. At a mean follow-up of 45 weeks, the treatment success was 75%. The medium term complications appeared in 25% of cases, which included three cases each of stent clogging, stent migration, infection and six cases of recurrence. There was no mortality.

Conclusion: EUS-guided drainage is an effective treatment for PPC with a successful outcome in most of patients. Most of the complications require minimal invasive surgical treatment or repeated EUS-guided drainage procedures.

Keywords: endoscopic ultrasound; pancreatic cyst; pancreatic pseudocyst drinage.

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Figures

Figure 1
Figure 1
The pancreatic pseudocysts and the pancreas were delineated by endoscopic ultrasound and a location most suitable for the puncture was selected. Doppler imaging was used to avoid any interposed vessels
Figure 2
Figure 2
The pseudocyst was punctured using a Giovannini needle
Figure 3
Figure 3
The pseudocyst was punctured using a 19-G aspiration needle
Figure 4
Figure 4
A guidewire was advanced over the needle and coiled-up inside the pseudocyst
Figure 5
Figure 5
A dilation catheter with a diameter of 8-10 mm was used to enlarge the tract
Figure 6
Figure 6
One stent was subsequently inserted
See this image and copyright information in PMC

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