scholarly journals Endoscopic Management of Pancreatic Pseudocysts

1994 ◽  
Vol 1 (1) ◽  
pp. 29-35 ◽  
Author(s):  
M. Dohmoto ◽  
K. D. Rupp
Keyword(s):  
Endoscopic Management ◽  
Pancreatic Pseudocysts ◽  
Simultaneous Increase ◽  
Endoscopic Drainage ◽  
Endoscopic Retrograde ◽  
Dominant Position ◽  
Pancreas Head ◽  
Endoscopic Findings ◽  
Reduction Of Pain ◽  
Nonsurgical Therapy

Recently, endoscopic interventional procedures were introduced for nonsurgical therapy of symptomatic pancreas pseudocysts. We reported 25 patients treated by endoscopic retrograde pancreas drainage (ERPD), endoscopic cystogastrostomy (ECG), or endosopic cystoduodenostomy (ECD).ERPD was performed in 9 patients by placement of a 5 Fr. or 7 Fr. endoprosthesis transpapillary into the cyst or the main pancreatic duct. ECG was carried out in 10 cases, in 7 of these, a double pigtail catheter was additionally inserted. Three patients suffering from pseudocysts of the pancreas head were treated by ECD. In a further 3 cases, ERPD and ECG were combined.All patients reported a dramatic reduction of pain with a simultaneous increase of appetite and body weight. The drainage tubes were removed after disappearance of symptoms, and abnormal clinical and endoscopic findings within 2 to 12 months. In 4 cases, a recurrence of the cyst was found 10 and 22 months later, in 3 cases the endoprostheses had to be renewed because of catheter occlusion or dislocation. 2 patient underwent surgical treatment after insufficient endoscopic drainage due to haemorrhage or recurrence.Endoscopic treatment of pancreatic pseudocysts yielded good results with low rates of recurrence and complications. According to our experiences we think endoscopic interventional techniques will oust surgery from its present dominant position in the next years.

scholarly journals Endoscopic management of pancreatic pseudocysts

2012 ◽  
Vol 03 (S 05) ◽  
pp. 058-064 ◽  
Author(s):  
Shyam Varadarajulu
Keyword(s):  
Percutaneous Drainage ◽  
Adjunctive Treatment ◽  
Endoscopic Management ◽  
Pancreatic Pseudocysts ◽  
Endoscopic Drainage ◽  
Conventional Management ◽  
Prolonged Hospitalization ◽  
Treatment Measures ◽  
Complications And Mortality

AbstractThe conventional management of pancreatic pseudocysts involves surgery or percutaneous drainage. While surgery is associated with significant complications and mortality, percutaneous drainage is associated with prolonged hospitalization and often times the need for other adjunctive treatment measures. Therefore, the use of endoscopy to drain these pseudocysts is becoming increasingly popular. In this review, we will be examining the techniques, outcomes and costs associated with the endoscopic drainage of pancreatic pseudocysts.

scholarly journals Endoscopic management of pancreatic pseudocyst

2017 ◽  
Vol 4 (8) ◽  
pp. 2577
Author(s):  
Wormi Sharon
Keyword(s):  
Pancreatic Pseudocyst ◽  
High Sensitivity ◽  
Cost Effective ◽  
Good Alternative ◽  
Venous Occlusion ◽  
Diagnostic Tools ◽  
Endoscopic Management ◽  
Pancreatic Pseudocysts ◽  
Endoscopic Drainage ◽  
Cystic Neoplasms

Background: Pancreatic pseudocyst is a well-known complication of acute or chronic pancreatitis, with a higher incidence in the latter. It represents 80-90% of cystic lesions of the pancreas. Benign and malignant cystic neoplasms constitute 10-13%, congenital and retention cysts comprising the remainder. Diagnosis is accomplished most often by computed tomographic scanning, by endoscopic retrograde cholangiopancreatography, or by ultrasound, and a rapid progress in the improvement of diagnostic tools enables detection with high sensitivity and specificity. Endoscopic drainage provides a good alternative or supplement to a surgical treatment of pancreatic pseudocysts.Methods: This is a prospective study of 26 patients diagnosed to have Pancreatic Pseudocyst and treated by endoscopic drainage from 1st June 2008 to 30th September 2010 in St. John’s Medical College and Hospital, Bangalore. Transabdominal and endoscopic ultrasound, CT scan were used to determine the number, size, volume, wall thickness, location of pancreatic pseudocysts, the extent of pancreatic parenchymal disease, the nature of the main pancreatic duct and its relationship to the cyst, the presence of portal hypertension, venous occlusion, arterial anomalies and pseudoaneurysm. The indications for endoscopic drainage were symptomatic and/or bigger than 6 cm in major diameter pancreatic pseudocysts with a close opposition to the gastric or duodenal wall.Results: There were 26 patients with pancreatic pseudocyst and all of them are located in lesser sac. It mainly affects the middle-aged males with alcohol as the main etiology. Out of 26 patients 24 underwent endoscopic drainage and 2 patients were abandoned in view of vessel between the cyst wall and stomach which was picked up by EUS. Out of 26 patients, 5 developed infection which was proven by culture. Endoscopic cystogastrostomy was performed in 21 patients (80.8%), endoscopic cystogastrostomy with nasocystic drainage performed in 3 patients (11.5%), and abandoned in 2 patients. 2 patients developed bleeding, and managed conservatively. No intervention done. 5 patients underwent re-procedure (3 underwent nasocystic drainage, 1 aspiration, and the other cystogastrostomy), in view of recollection.Conclusions: Endoscopic drainage is safe and effective in experienced hand, less morbidity, cost effective, short hospital stay, can be repeated.

scholarly journals Utility of endoscopic transpapillary pancreatic cyst drainage for intraductal papillary mucinous neoplasm infection

2021 ◽  
Vol 14 (6) ◽  
pp. e242583
Author(s):  
Shunsuke Watanabe ◽  
Masao Toki ◽  
Junji Shibahara ◽  
Tadakazu Hisamatsu
Keyword(s):  
Intraductal Papillary Mucinous Neoplasm ◽  
Cyst Wall ◽  
Pancreatic Cyst ◽  
Epigastric Pain ◽  
Drainage Tube ◽  
Endoscopic Drainage ◽  
Endoscopic Retrograde Pancreatography ◽  
Endoscopic Retrograde ◽  
Mucinous Neoplasm ◽  
Route Of Infection

A 61-year-old woman with intraductal papillary mucinous neoplasm (IPMN) infection, who was treated with antibiotics, developed IPMN reinfection with febrile epigastric pain and was febrile. CT showed that the diameter of the IPMN had grown and hardened, with thickening of the cyst wall. Endoscopic retrograde pancreatography was then performed and a nasopancreatic cyst drainage tube was placed into the cyst. Symptoms and inflammatory findings improved considerably 17 days after endoscopic drainage. Few reports and evidence have been found regarding IPMN infections, and the frequency of onset, route of infection and optimal drainage method remain unknown. This study indicated that endoscopic transpapillary pancreatic cyst drainage was effective and is highly recommended for IPMN infection.

Endoscopic management of pancreatic pseudocysts or abscesses after an EUS-guided 1-step procedure for initial access

2006 ◽  
Vol 63 (3) ◽  
pp. 409-416 ◽  
Author(s):  
Martin Krüger ◽  
Andrea S. Schneider ◽  
Michael P. Manns ◽  
Peter N. Meier
Keyword(s):  
Endoscopic Management ◽  
Pancreatic Pseudocysts ◽  
Step Procedure

scholarly journals Endoscopic Drainage of Pancreatic Pseudocysts: An Experience with 77 Patients

2017 ◽  
Vol 08 (02) ◽  
pp. 061-067
Author(s):  
Hemanta K. Nayak ◽  
Sandeep Kumar ◽  
Uday C. Ghoshal ◽  
Samir Mohindra ◽  
Namita Mohindra ◽  
...  
Keyword(s):  
Long Term Results ◽  
Pancreatic Pseudocysts ◽  
Endoscopic Drainage ◽  
Stent Occlusion ◽  
Northern India ◽  
Short And Long Term ◽  
Transpapillary Drainage ◽  
And Migration ◽  
Lost To Follow Up

ABSTRACT Background: We evaluated short‑ and long‑term results of endoscopic drainage (a minimally invasive nonsurgical treatment) of pancreatic pseudocysts (PPCs) and factors associated with its success at a multilevel teaching hospital in Northern India, as such data are scanty from India. Patients and Methods: Retrospective review of records of consecutive patients undergoing endoscopic drainage of PPC from January 2002 to June 2013 was undertaken. Results: Seventy‑seven patients (56 males), median age 36 years (range, 15–73), underwent endoscopic drainage of PPC with 98% technical success. Pseudocysts drained were symptomatic (duration 11 weeks, range, 8–68), large (volume 582 mL [range, 80–2706]), located in head (n = 32, 46%), body and tail (n = 37, 54%), and infected (n = 39, 49%). Drainage procedures included cystogastrostomy (n = 54, 78%), cystoduodenostomy (n = 9, 13%), transpapillary drainage (n = 2, 3%), and multiple route (n = 4, 6%), with additional endoscopic nasocystic drainage (ENCD) in 41 (59%). Sixty‑nine patients were followed up (median 28 months, range 2–156; other eight lost to follow‑up). Complications (n = 21, 30%) included stent occlusion and migration (13), bleeding (5), perforation (2), and death (1). Endoscopic procedure had to be repeated in 19 patients (28%; 16 for sepsis, 3 for recurrence). The reasons for additional nonendoscopic treatment (n = 8, 12%) included incomplete cyst resolution (3), recurrence (2), bleeding (1), and perforation (2). Overall success rate of endoscopic drainage was 88%. Whereas infected pseudocysts were associated with poorer outcome (odds ratio [OR] 0.016; 95% confidence interval [CI] 0.001–0.037), placement of ENCD led to better results (OR 11.85; 95% CI 1.03–135.95). Conclusion: Endoscopic drainage is safe and effective for PPC.

scholarly journals A rare case of pseudocyst in remnant pancreas after classical pancreaticoduodenectomy- treated by endoscopic drainage

2017 ◽  
Vol 4 (5) ◽  
pp. 1797
Author(s):  
Senthilkumar Perumal ◽  
Jeswanth Sathyanesan ◽  
Ravichandran Palaniappan
Keyword(s):  
Female Patient ◽  
Rare Case ◽  
Malignant Tumors ◽  
Pancreatic Pseudocysts ◽  
Endoscopic Drainage ◽  
Cystic Lesions ◽  
Periampullary Carcinoma ◽  
Pancreatic Anastomosis ◽  
Remnant Pancreas

Pancreatic pseudocysts comprise more than 80 % of the cystic lesions of the pancreas. Here we report a 45-year-old female patient who developed a symptomatic pseudocyst in the remnant pancreas following classical pancreaticoduodenectomy for periampullary carcinoma. The pancreatic anastomosis was pancreaticogastrostomy- Dunking technique. She underwent endoscopic cystogastrostomy. Recurrence should always be ruled out before diagnosing pseudocyst in remnant pancreas following pancreaticoduodenectomy for malignant tumors.

Treatment of Pancreatic Pseudocysts

2005 ◽  
Vol 94 (2) ◽  
pp. 165-175 ◽  
Author(s):  
Å. Andrén-Sandberg ◽  
C. Ansorge ◽  
K. Eiriksson ◽  
T. Glomsaker ◽  
A. Maleckas
Keyword(s):  
Acute Pancreatitis ◽  
Conservative Treatment ◽  
Pancreatic Juice ◽  
Granulation Tissue ◽  
Spontaneous Resolution ◽  
Pancreatic Pseudocysts ◽  
Endoscopic Drainage ◽  
Pancreatic Trauma ◽  
Choice Of Procedure ◽  
Substantial Risk

According to the Atlanta classification an acute pseudocyst is a collection of pancreatic juice enclosed by a wall of fibrous or granulation tissue, which arises as a consequence of acute pancreatitis or pancreatic trauma, whereas a chronic pseudocyst is a collection of pancreatic juice enclosed by a wall of fibrous or granulation tissue, which arises as a consequence of chronic pancreatitis and lack an antecedent episode of acute pancreatitis. It is generally agreed that acute and chronic pseudocysts have a different natural history, though many reports do not differentiate between pseudocysts that complicate acute pancreatitis and those that complicate chronic disease. Observation — “conservative treatment” — of a patient with a pseudocyst is preponderantly based on the knowledge that spontaneous resolution can occur. It must, however, be admitted that there is substantial risk of complications or even death; first of all due to bleeding. There are no randomized studies for the management protocols for pancreatic pseudocysts. Therefore, today we have to rely on best clinical practice, but still certain advice may be given. First of all it is important to differentiate acute from chronic pseudocysts for management, but at the same time not miss cystic neoplasias. Conservative treatment should always be considered the first option (pseudocysts should not be treated just because they are there). However, if intervention is needed, a procedure that is well known should always be considered first. The results of percutaneous or endoscopic drainage are probably more dependent on the experience of the interventionist than the choice of procedure and if surgery is needed, an intern anastomosis can hold sutures not until several weeks (if possible 6 weeks).

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