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- Title
A simple, safe technique for the drainage of pancreatic pseudocysts.
- Authors
Thomasset, Sarah C.; Berry, David P.; Garcea, Giuseppe; Ong, Seok L.; Hall, Thomas; Rees, Yvonne; Sutton, Christopher D.; Dennison, Ashley R.
- Abstract
Background: A number of methods are available for the drainage of pancreatic pseudocysts, including percutaneous, endoscopic and open approaches. In Leicester, we developed a combined radiological and endoscopic technique (predating the use of endoscopic/ultrasound) to allow drainage of pancreatic pseudocysts into the stomach. The aim of the study was to evaluate the long-term results of this approach. Methods: This is a retrospective study of patients undergoing combined endoscopic/ultrasound-guided percutaneous stenting between 1994 and 2007. Data were extracted from case records and our computerised radiology database. Results: Thirty-seven combined endoscopic/ultrasound-guided procedures were undertaken. Median patient age was 52 years (range 26-84 years). Nineteen pseudocysts were secondary to acute pancreatitis and 18 were in patients with chronic pancreatitis. The diameter of pseudocysts on pre-procedure imaging ranged from 4 to 21 cm (median 11 cm). Median duration of hospital stay was 7 days (range 1-44 days) and 30-day mortality was 0%. Stents were inserted in 70.3% of patients ( n= 26). Of those patients stented during the combined procedure, three developed infection of the pseudocyst, necessitating open cystgastrostomy within the first month. During a mean follow-up period of 41 months, two patients developed recurrent pseudocysts which were successfully drained with a further combined procedure (16 and 43 months). Repeat imaging in the remainder of patients failed to show any evidence of a persistent or recurrent pseudocyst beyond 2 months. Conclusion: Combined radiological and endoscopic drainage is safe, cost-effective and highly efficient in preventing recurrent pseudocyst formation.
- Subjects
LEICESTER (England); ENGLAND; PANCREATIC cysts; PANCREATITIS; RADIOLOGICAL research; ENDOSCOPIC surgery; SURGICAL stents; ENDOSCOPY
- Publication
ANZ Journal of Surgery, 2010, Vol 80, Issue 9, p609
- ISSN
1445-1433
- Publication type
Article
- DOI
10.1111/j.1445-2197.2010.05402.x