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DOI: 10.1055/s-2003-43439
© Georg Thieme Verlag Stuttgart · New York
Endoskopische Drainage von symptomatischen Pankreaspseudozysten
Eine effiziente und sichere Therapie in der klinischen Routine?Endoscopic drainage of symptomatic pancreatic pseudocystsAn efficacious and safe routine clinical treatment?Publication History
eingereicht: 14.4.2003
akzeptiert: 17.7.2003
Publication Date:
06 November 2003 (online)

Hintergrund und Fragestellung: Klinische Studien haben für die endoskopisch-interventionelle Therapie von Pankreaspseudozysten hervorragende Erfolgsraten bei niedriger Komplikationsrate gezeigt. Ob diese guten Resultate auch in der klinischen Routine gastroenterologischer Zentren erreichbar sind, ist nicht bekannt.
Patienten und Methodik: Die Ergebnisse der endoskopischen Pseudozystentherapie bei 21 Patienten (15 Männer, 6 Frauen) im Alter von 40-81 Jahren aus den Jahren 1997-2002 wurden ausgewertet. Dies schloss eine aktuelle Nachuntersuchung ein.
Ergebnisse: Vergleichbar mit vorliegenden Studienergebnissen zeigte sich ein initialer symptomatischer Erfolg bei 18/21 Patienten und ein symptomatisches Rezidiv bei nur zwei Patienten. Die eingriffsbedingten Komplikationen konnten konservativ beherrscht werden.
Folgerung: Die Ergebnisse klinischer Studien einer endoskopisch-interventionellen Pseudozystentherapie sind in einem gastroenterologischen Zentrum in der klinischen Routine erreichbar und lassen ein chirurgisches Vorgehen für die Fälle, bei denen der endoskopische Erfolg ausbleibt, in den Hintergrund treten.
Background and objective: Clinical studies have demonstrated excellent success and low complication rates of endoscopic therapy of pancreatic pseudocysts. But it is not known, if these results can be reached in gastroenterological centers outside clinical studies.
Patients and methods: We investigated the outcome of endoscopic therapy in 21 patients (15male, 6 female, age 40 - 81) with pancreatic pseudocysts treated in our clinic between 1997 and 2002. A follow-up examination was included.
Results: Similar to the results of reported clinical studies the initial clinical success rate was 18/21 with symptomatic recurrences in two patients. All therapy-induced complications were successfully treated conservatively.
Conclusion: Excellent results of endoscopic therapy of pancreatic pseudocysts can be reached in a gastroenterological center. Surgical treatment can be reserved for cases, when endoscopic therapy fails.
Literatur
- 1
Adams D B, Anderson M C.
Percutaneous catheter drainage compared with internal drainage in the management
of pancreatic pseudocyst.
Ann Surg.
1992;
215
571-576
Reference Ris Wihthout Link
- 2
Barthet M, Bugallo M, Moreira L S, Bastid C, Sastre B, Sahel J.
Management of cysts and pseudocysts complicating chronic pancreatitis: A retrospective
study of 143 patients.
Gastroenterol Clin Biol.
1993;
17
270-276
Reference Ris Wihthout Link
- 3
Barthet M, Sahel J, Bodiou-Bertei C, Bernard J P.
Endoscopic transpapillary drainage of pancreatic pseudocysts.
Gastrointest Endosc.
1995;
42
208-213
Reference Ris Wihthout Link
- 4
Beckingham I J, Krige J E, Bornman P C, Terblanche J.
Long term outcome of endoscopic drainage of pancreatic pseudocysts.
Am J Gastroenterol.
1999;
94
71-74
Reference Ris Wihthout Link
- 5
Bradley E L.
Cysts and pseudocysts of the pancreas: Surgical aspects.
Gastroenterology.
1985;
6
4151-4157
Reference Ris Wihthout Link
- 6
Bradley E L, Clements J L, Gonzalez A C.
The natural history of pancreatic pseudocysts: a unified concept of management.
Am J Surg.
1979;
137
135-41
Reference Ris Wihthout Link
- 7
Catalano M F, Geenen J E, Schmalz M J, Johnson G K, Dean R S, Hogan W J.
Treatment of pancreatic pseudocysts with ductal communication by transpapillary pancreatic
duct endoprosthesis.
Gastrointest Endosc.
1995;
42
214-218
Reference Ris Wihthout Link
- 8
Cremer M, Deviere J, Engelholm L.
Endoscopic management of cysts and pseudocysts in chronic pancreatitis: long-term
follow-up after 7 years of experience.
Gastrointest Endosc.
1989;
35
1-9
Reference Ris Wihthout Link
- 9
De Palma G D, Galloro G, Puzziello A, Masone S, Persico G.
Endoscopic drainage of pancreatic pseudocysts: a long-term follow-up study of 49
patients.
Hepatogastroenterology.
2002;
49
1113-1115
Reference Ris Wihthout Link
- 10
Giovannini M, Bernardini D, Seitz J F.
Cystogastrotomy entirely performed under endosonography guidance for pancreatic pseudocyst:
results in six patients.
Gastrointest Endosc.
1998;
48
200-203
Reference Ris Wihthout Link
- 11
Giovannini M, Pesenti C, Rolland A L. et al .
Endoscopic ultrasound-guided drainage of pancreatic pseudocysts or pancreatic abscesses
using a therapeutic echo endoscope.
Endoscopy.
2000;
32
255-259
Reference Ris Wihthout Link
- 12
Gouyon B, Levy P, Ruszniewski P. et al .
Predictive factors in outcome of pseudocysts complicating alcoholic chronic pancreatitis.
Gut.
1997;
41
821-826
Reference Ris Wihthout Link
- 13
Heyder N, Gunter E, Hahn E G.
Endoscopic-sonographic control of cystogastric catheter drainage of pancreatogenic
fluid collections.
Z Gastroenterol.
1992;
30
553-557
Reference Ris Wihthout Link
- 14
Huibregtse K, Schneider B, Vrij A A, Tytgat G N.
Endoscopic pancreatic drainage in chronic pancreatitis.
Gastrointest Endosc.
1988;
34
9-15
Reference Ris Wihthout Link
- 15
Kozarek R A, Brayko C M, Harlan J, Sanowski R A, Cintora I, Kovac A.
Endoscopic drainage of pancreatic pseudocysts.
Gastrointest Endosc.
1985;
31
322-327
Reference Ris Wihthout Link
- 16
Lo S K, Rowe A.
Endoscopic management of pancreatic pseudocysts.
Gastroenterologist.
1997;
5
10-25
Reference Ris Wihthout Link
- 17
O’Malley V P, Cannon J P, Postier R G.
Pancreatic pseudocysts: cause, therapy, and results.
Am J Surg.
1985;
150
680-682
Reference Ris Wihthout Link
- 18
Pitchumoni C S, Agarwal N.
Pancreatic pseudocysts. When and how should drainage be performed?.
Gastroenterol Clin North Am.
1999;
28
615-39
Reference Ris Wihthout Link
- 19
Rapp K, Zundler J, Walker S.
Nicht-operative Verfahren zur Behandlung von Pankreaspseudozysten.
Dtsch Med Wochenschr.
1995;
120
1129-1132
Reference Ris Wihthout Link
- 20
Seifert H, Faust D, Schmitt T. et al .
Transmural drainage of cystic peripancreatic lesions with a new large-channel echo
endoscope.
Endoscopy.
2001;
33
1022-1026
Reference Ris Wihthout Link
- 21
Smits M E, Rauws E A, Tytgat G N, Huibregtse K.
The efficacy of endoscopic treatment of pancreatic pseudocysts.
Gastrointest Endosc.
1995;
42
202-207
Reference Ris Wihthout Link
- 22
Van Sonnenberg E, Wittich G R, Casola G. et al .
Percutaneous drainage of infected and non-infected pancreatic pseudocysts: experience
in 101 cases.
Radiology.
1989;
170
757-761
Reference Ris Wihthout Link
- 23
Vitale G C, Lawhon J C, Larson G M, Harrell G J, Reed D N, MacLeod S.
Endoscopic drainage of the pancreatic pseudocyst.
Surgery.
1999;
126
616-621
Reference Ris Wihthout Link
- 24
Yeo C J, Sarr M G.
Cystic and pseudocystic diseases of the pancreas.
Curr Probl Surg.
1994;
31
167-243
Reference Ris Wihthout Link
Prof. Dr. med. Jürgen F. Riemann
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