Endoscopic Transmural Drainage Of Pancreatic Pseudocysts

Aims Pancreatic pseudocysts (PPC) are collections of fluids containing pancreatic juice and can occur as a result of acute pancreatitis or in patients with chronic pancreatitis. They are most often asymptomatic and resolve spontaneously, but in some cases, endoscopic or surgical treatment is indicated. The aim of this work was to identify methods of endoscopic drainage of pancreatic pseudocysts and to evaluate their results.

Methods This is a retrospective study including all patients who underwent endoscopic drainage of PPC in our department between November 2001 and June 2019. Epidemiological, clinical and therapeutic features were studied.

Results We included 16 patients. The average age was 38 years (5-68 years). PPC had appeared after acute pancreatitis in all cases with a mean time to discovery of 4 weeks (2 - 8 weeks). PPC was symptomatic in 8 cases. It was unique in most cases (n = 15) and its average size was 12 centimeters in diameter (range: 7 - 20 centimeters). One or more complications were noted in 11 cases: digestive compression in 8 cases, vascular compression in 3 cases and surinfection in one case. The endoscopic drainage technique consisted of the confection by the sphincterotome of a cysto-gastric fistula with an average diameter of 10 mm, then a pigtail transmural stent was placed. The cysto-gastrostomy allowed efficient drainage of PPC in 13 patients. No complications were observed during or following endoscopic drainage except for a single case of moderate bleeding that resolved spontaneously.The cysto-gastrostomy failed in three patients who had to be operated.

Conclusions Endoscopic PPC drainage is a simple and effective method of treating large symptomatic PPC, making it possible to reserve surgery for cases of endoscopic failure. However, a larger-scale study is needed to determine the predictors of endoscopic drainage failure and thus early select patients for surgery.

Citation Bradai S, Mahmoudi M, Khsiba A et al. eP338 ENDOSCOPIC TRANSMURAL DRAINAGE OF PANCREATIC PSEUDOCYSTS. Endoscopy 2021; 53: S208.

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Artikel online veröffentlicht:
19. März 2021