Endoscopic stent implantation seems to be a safe and efficient palliative approach to selected patients with obstructing rectal cancer. Currently, self-expanding coil stents are superior to other devices because of lower risk of dislocation and tumor ingrowth.
EUS with a curved-array transducer provides high accuracy rates in staging of esophageal carcinoma. Evaluation of gastric cancer with this technique appears to be more difficult than with radial transducers. A major advantage of the linear transducer is the ability to perform EUS-guided biopsies of submucosal or extamural lesions.
Summary. Seventeen patientswith pancreatic pseudocysts were treated by endoscopic drainage. In nine cases we performed endoscopic retrograde pancreatic drainage (ERPD) by inserting 7-Fr pigtail catheters via the papilla into the cyst or into the main pancreatic duct. In two cases transduodenal cystotomy (ECD) and in eight cases transgastral cystotomy (ECG) are performed by using coagulator and papillotome. In five cases of ECG an endoprosthesis was inserted into the cyst. In two cases combination therapy of ERPD and ECG was performed. All patients reported reduction of continuous pain and postprandial epigastralgia after placement of endoprosthesis. After disappearance of symptoms and abnormal endoscopic findings within a period of 2-12 months the drainage tubes were removed. In one case postoperative dislocation of the prosthesis was observed; no serious complication was not encountered. The period of observation varied from 5 to 40 months. Two patients are presently under treatment with endoprostheses. Endoscopic drainage yielded good results in the treatment of pancreatic pseudocysts.
Key words: Pancreatic pseudocyst-Endoscopic drainage -Transduodenal cystotomyPancreatic pseudocysts require drainage if they cause symptoms such as pain or loss of appetite or complications like bleeding, infection, or jaundice due to compression of the common bile duct. Asymptomatic but large cysts with a high risk of developing complications should also be treated by drainage. Many therapeutic procedures such as external drainage with nasocystic tubes or CT and sonographically guided percutaneous drainages exist.The rates of recurrence, however, amount to 20-25%, and there are many cases of persistent pancreatiOffprint requests to: M. Dohmoto cocutaneous fistula. The conventional surgical treatment by construction of an internal connection between the cyst and the gastrointestinal tract has a high rate of complication and mortality. So endoscopic procedures with the advantage of less complications and less discomfort for the patient have been developed recently.
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