Endoscopic cystogastrostomy during pregnancy

Gyökeres, T; Topa, L; Marton, I; Pap, Ákos

doi:10.1067/mge.2001.112039

Cited by 14 publications

(5 citation statements)

References 14 publications

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“…One pregnant patient was referred for endoscopic cystogastrostomy to drain a pancreatic pseudocyst at 21 weeks of gestation because of concern that the pseudocyst might rupture near term due to increasing intraabdominal pressure exerted by the growing gravid uterus. 231 The pseudocyst was punctured percutaneously under conventional abdominal ultrasound (not EUS) guidance, aspirated, and filled with contrast agent. The pseudocyst was then entered endoscopically from the stomach using a needle-knife under fluoroscopic guidance.…”

Section: Endoscopic Cystogastrostomymentioning

confidence: 99%

Risks versus benefits of gastrointestinal endoscopy during pregnancy

Cappell

2011

Nat Rev Gastroenterol Hepatol

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Although gastrointestinal endoscopy is generally safe, its safety must be separately analyzed during pregnancy with regard to fetal safety. Fetal risks from endoscopic medications are minimized by avoiding FDA category D drugs, minimizing endoscopic medications, and anesthesiologist attendance at endoscopy. Esophagogastroduodenoscopy seems to be relatively safe for the fetus and may be performed when strongly indicated during pregnancy. Despite limited clinical data, endoscopic banding of esophageal varices and endoscopic hemostasis of nonvariceal upper gastrointestinal bleeding seems justifiable during pregnancy. Flexible sigmoidoscopy during pregnancy also appears to be relatively safe for the fetus and may be performed when strongly indicated. Colonoscopy may be considered in pregnant patients during the second trimester if there is a strong indication. Data on colonoscopy during the other trimesters are limited. Therapeutic endoscopic retrograde cholangiopancreatography seems to be relatively safe during pregnancy and should be performed for strong indications (for example, complicated choledocholithiasis). Endoscopic safety precautions during pregnancy include the performance of endoscopy in hospital by an expert endoscopist and only when strongly indicated, deferral of endoscopy to the second trimester whenever possible, and obstetric consultation.

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Section: Endoscopic Cystogastrostomymentioning

confidence: 99%

Risks versus benefits of gastrointestinal endoscopy during pregnancy

Cappell

2011

Nat Rev Gastroenterol Hepatol

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“…Two cases of endoscopic cystogastrostomy have been described in the literature under abdominal ultrasound guidance (not EUS) at 17th and 21st week of gestation. 64,65 Postprocedure pain and leucocytes have been described which was successfully treated with antibiotics and placement of additional cyst-gastric stents. Hence, endoscopic cystogastrostomy in the current era with EUS guidance is a useful option in pregnant female with symptomatic pancreatic fluid collections as an alternative to surgical cystogastrostomy.…”

Section: Endoscopic Cystogastrostomymentioning

confidence: 99%

Endoscopy in Pregnancy: A Systematic Review

Pal

Reddy

Tandan

2021

Journal of Digestive Endoscopy

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Background Fetomaternal outcomes are of primary concern for gastrointestinal (GI) endoscopy in pregnancy. We aimed to systematically review the safety and utility of endoscopic procedures in pregnancy. Methods A systematic literature search was performed using PubMed. All original research articles with sample size > 10 involving endoscopy in pregnancy were included for the review along with case report/series describing novel/rare techniques from 1948 to July 2021. Results After screening 12,197 references, 216 citations were found and finally 66 references were included. Esophagogastroduodenoscopy had favorable fetal outcome (>95%) based on two large retrospective studies and a review of case reports. Sclerotherapy and band ligation of varices were safe according to case series. A large nationwide cohort study established safety of endotherapy for nonvariceal bleed. Botulinum toxin and pneumatic dilation in achalasia are only supported by case reports. Percutaneous endoscopic gastrostomy can be useful to support nutrition based on case reports. A retrospective case–control and cohort study with systemic review justified flexible sigmoidoscopy if strongly indicated. Low birth weight was more common when sigmoidoscopy was done in inflammatory bowel disease based on a prospective study. Colonoscopy was considered safe in second trimester based on a case–control study whereas it can be performed otherwise only in presence of strong indication like malignancy. Capsule endoscopy is promising and can be useful in acute small bowel bleeding although risk of capsule retention is unknown. There are no reports of enteroscopy in pregnancy. Twelve retrospective studies and one prospective study showed high success rate of therapeutic endoscopic retrograde cholangiopancreatography (ERCP) (> 90%) in all trimesters and can be performed if strongly indicated. Pregnancy was an independent risk factor for post-ERCP pancreatitis in a large nationwide case–control study. Radiation-free ERCP with wire-guided bile observation, stent-guided or precut sphincterotomy, endoscopic ultrasound (EUS) guidance, and spyscopy have been described. Safety of EUS is limited to case series and can be used in intermediate probability of choledocholithiasis to guide ERCP and endoscopic cystogastrostomy. Conclusion This review concludes that GI endoscopy during pregnancy can be done effectively if strongly indicated with good fetomaternal outcomes. Precautions are advocated during procedures where radiation exposure is expected.

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“…In the second patient unfortunately the stent was migrated making the procedure partially unsuccessful, but with other techniques patient again got well and gave birth to a healthy infant too. So according to these two cases endoscopic cystogastrostomy is still a little bit experimental during pregnancy, it should be considered in pregnants who have symptomatic pseudocysts and cannot delay the procedure until delivery [4,29,[116][117][118].…”

Section: Endoscopic Cystogastrostomymentioning

confidence: 99%

Endoscopy in Pregnant Patients

Savas¹

2013

Endoscopy

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Endoscopic cystogastrostomy during pregnancy

Cited by 14 publications

References 14 publications

Risks versus benefits of gastrointestinal endoscopy during pregnancy

Risks versus benefits of gastrointestinal endoscopy during pregnancy

Endoscopy in Pregnancy: A Systematic Review

Endoscopy in Pregnant Patients

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