Single-step EUS-guided transmural drainage of simple and complicated pancreatic pseudocysts - 19/08/11
Reprint requests: Yang K. Chen, MD, University of Colorado Hospital, Anschutz Centers for Advanced Medicine, 1635 N. Ursula St, Rm OP 6710, Aurora, CO 80010-0510.Denver, Colorado, USA
Abstract |
Background |
Single-step EUS-guided transmural drainage of pseudocysts has been reported, but there are no published prospective studies on clinical outcomes.
Objective |
To assess the safety and the efficacy of single-step EUS-guided placement of large endoprostheses to treat simple and complicated pseudocysts.
Design |
Prospective cohort study.
Setting |
Single tertiary referral center.
Patients |
Consecutive patients referred for management of symptomatic chronic pancreatic pseudocysts >4 cm in size.
Interventions |
Single-step EUS-guided transmural pseudocyst drainage performed with a linear-array echoendoscope for placement of 10F stents in adults and 7F stents in children.
Main Outcome Measures |
Complete or partial (>50% reduction) resolution of pseudocyst on follow-up imaging, recurrence, clinical response, and procedure-related complications. Recurrence was defined as the reappearance of a pancreatic pseudocyst in the same location.
Results |
There were 33 patients, with a mean age of 43 years. Median pseudocyst size was 8.5 cm (range, 4-20 cm). Fourteen patients (42%) had infected pseudocysts, 8 patients (24%) had gastric varices, and 16 patients (48%) had no visible endoscopic bulge. Stent placement was successful in 31 patients (94%). Twenty-seven patients (82%) had complete resolution of a pseudocyst; 4 patients (12%) had partial resolution, with symptom relief. There were 2 major complications and 3 minor complications. Recurrence of a pseudocyst was observed in only 1 patient over a median follow-up of 46 weeks.
Limitations |
No randomized treatment arm comparing this technique with conventional endoscopic drainage.
Conclusions |
Single-step EUS-guided transmural drainage with large endoprostheses is a safe and effective therapy for patients with simple and complicated pancreatic pseudocysts.
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| Presented in part at Digestive Disease Week, Orlando, Florida, May 17-22, 2003. |
Vol 63 - N° 6
P. 797-803 - mai 2006 Regresar al número
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