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 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.

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

Treatment of pancreatic pseudocysts with percutaneous drainage and octreotide. Work in progress.

Radiology ◽  
1993 ◽  
Vol 187 (3) ◽  
pp. 685-688 ◽  
Author(s):  
H B D'Agostino ◽  
E vanSonnenberg ◽  
R B Sanchez ◽  
B W Goodacre ◽  
R G Villaveiran ◽  
...  
Keyword(s):  
Percutaneous Drainage ◽  
Pancreatic Pseudocysts ◽  
Work In Progress

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 Kasos pseudocistų gydymas perkutaniniu drenavimu

2004 ◽  
Vol 2 (3) ◽  
pp. 0-0
Author(s):  
Alfredas Radziminskas ◽  
Artūras Razbadauskas ◽  
Bronius Stanislovaitis
Keyword(s):  
Percutaneous Drainage ◽  
New Technologies ◽  
Necrotizing Pancreatitis ◽  
Invasive Procedure ◽  
Acute Necrotizing Pancreatitis ◽  
Pancreatic Pseudocysts ◽  
Drainage Procedure ◽  
Acute Necrotizing ◽  
One Year

Alfredas Radziminskas1, Artūras Razbadauskas2, Bronius Stanislovaitis11 Klaipėdos jūrininkų ligoninės Chirurgijos klinika2 Klaipėdos universitetas, VšĮ Klaipėdos jūrininkų ligoninė,Liepojos pl. 45, LT-92288, KlaipėdaEl. paštas [email protected], [email protected] Įvadas / tikslas Ūminio pankreatito ir jo komplikacijų gydymas, nepaisant šiuolaikinių medicinos technologijų bei naujų vaistų, tebėra sudėtingas. Mūsų tyrimo tikslas – įvertinti vienos iš ūminio pankreatito komplikacijų – kasos pseudocistos – gydymo perkutaniniu drenavimu ankstyvuosius ir vienerių metų rezultatus Klaipėdos jūrininkų ligoninėje. Ligoniai ir metodai 1998–2003 metais nuo kasos pseudocistų gydyti 23 ligoniai – 15 (65%) vyrų ir 8 (35%) moterys. Visiems pacientams kasos pseudocistos susidarė persirgus ūminiu nekroziniu pankreatitu. Ligos istorijų retrospektyviosios analizės būdu įvertinti ligonių demografiniai duomenys, ligos trukmė, kasos pseudocistų morfologiniai ypatumai. Gydymo rezultatai vertinti apklausos ir sonoskopijos būdais. Rezultatai Iš viso drenuotos 29-ios kasos pseudocistos. Vienam ligoniui drenuotos trys kasos pseudocistos. Trims ligoniams padaryta po dvi perkutaninio drenavimo operacijas. Dažniausia kasos pseudocistų lokalizacija – kasos galva. Vidutinis drenavimo laikas – 21 para. Pasitaikė 3 komplikacijos (10%). Vienam ligoniui buvo pažeista skersinė gaubtinė žarna. Dviem ligoniams drenas iškrito iš pseudocistos ertmės – vienam tai įvyko antrąją, kitam – 12-ą drenavimo parą. Visi ligoniai pasveiko. Praėjus vieneriems metams visi 12 ligonių nusiskundimų neturėjo. Echoskopiškai atsinaujinusių kasos pseudocistų nerasta. Išvados Perkutaninis drenavimas – tinkamas būdas gydant pacientus, kuriems ūminis nekrozinis pankreatitas komplikavosi progresuojančiomis kasos pseudocistomis. Tai – saugi, veiksminga, patikima ir pigi minimaliai invazyvi gydomoji operacija. Reikšminiai žodžiai: ūminis nekrozinis pankreatitas, kasos pseudocistos, perkutaninis drenavimas Percutaneous drainage treatment of pancreatic pseudocysts Alfredas Radziminskas1, Artūras Razbadauskas2, Bronius Stanislovaitis1 Background / objective Despite all merits of the new technologies and medications to medical practice, treatment of acute pancreatitis and its complications still remains problematic. The aim of our study was to evaluate early and one-year follow-up results of sonoscopically-guided percutaneous drainage of pancreatic pseudocysts in Klaipėda Seamen’s Hospital. Patients and methods From 1998 to 2003, 23 patients – 15 (65%) male and 8 (35%) female – were treated for pancreatic pseudocysts which have developed due to acute necrotic pancreatitis. A retrospective analysis of case histories, laboratory and instrumental examination data, morphologic peculiarities of pancreatic pseudocysts was done. Twelve study patients were interrogated using standard questionnaires and examined by ultrasound following one year after sonoscopically-guided percutaneous drainage procedure. Results We have performed 29 percutaneous drainage procedures of pancreatic pseudocysts under ultrasound control. Three pancreatic pseudocysts were drained in one patient. The percutaneous drainage procedure was done twice in three patients. Pancreatic pseudocysts involved the head of pancreas in the majority of patients. Mean drainage time was 21 days. Symptoms subsided in all the patients. Complications occurred in three patients (10%). The transverse colon has been damaged in one patients. Drainage tubes prolapsed out completely from the cavity of the pancreatic pseudocyst in two patients. The follow up showed that all patients felt well and there were no recurrencies of pancreatic pseudocysts. Conclusions Sonoscopically-guided percutaneous drainage is a suitable treatment of acute necrotizing pancreatitis complicated by progressive pancreatic pseudocysts. It is a safe, effective and cheap minimally invasive procedure. Keywords: acute necrotizing pancreatitis, pancreatic pseudocysts, percutaneous drainage

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.

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