Transpapillary and transmural drainage of pancreatic pseudocysts

Binmoeller, Kenneth F.; Seifert, H.; Walter, Andreas; Soehendra, Nib

doi:10.1016/s0016-5107(95)70095-1

Cited by 313 publications

(194 citation statements)

References 12 publications

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“…Binmoeller et al reported 53 patients with symptomatic pancreatic pseudocysts, managed by transpapillary drainage in 33 cases, transmural drainage in 20 cases, and by a combined approach in the remaining 4 cases [29]. The mean diameter of the pseudocysts was 7 cm, in 92% of cases the cause being chronic pancreatitis.…”

Section: Discussionmentioning

confidence: 99%

“…The mean diameter of the pseudocysts was 7 cm, in 92% of cases the cause being chronic pancreatitis. Complications occurred in 11% of cases, after a mean follow-up of 22 months [29]. In patients with a pancreatic duct disruption that could be bridged, transpapillary pancreatic duct stenting improved outcomes in patients with endoscopic transmural drainage of peripancreatic fluid collections [30].…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic Transgastric versus Endoscopic Drainage of a Large Pancreatic Pseudocyst. A Case Report

Beuran

Negoi

Catena

et al. 2016

JGLD

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Case report: A 37 year-old woman was admitted three months after an episode of severe acute pancreatitis with a large tumor mass located in her left abdomen, abdominal tenderness and asthenia. Abdominal Computed Tomography (CT) revealed a giant pancreatic pseudocyst of 23/15/12 centimeters. We performed an anterior laparoscopic transgastric cystogastrostomy. The postoperative clinical course was uneventful, and she was discharged nine days later. After another month she was re-admitted for general malaise and fever. We performed endoscopic evaluation of the cystogastrostomy patency followed by lavage of the pseudocyst cavity. After five days of broad spectrum antibiotic therapy the clinical course started to improve and the patient was discharged after another eight days. One- and two-year follow-ups revealed no remnant cavity. Conclusions: Laparoscopic transgastric cystogastrostomy is a feasible option for selected patients with pancreatic pseudocysts. Careful patients’ evaluation in a multidisciplinary team, including imaging specialists, dedicated gastroenterologists with experience in advanced interventional techniques and pancreatic surgeons, balancing between watchful waiting and step-up minimally invasive approach offers the best tailored approach for a specific patient.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Laparoscopic Transgastric versus Endoscopic Drainage of a Large Pancreatic Pseudocyst. A Case Report

Beuran

Negoi

Catena

et al. 2016

JGLD

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“…With the development of endoscopic techniques and new implantable materials, the surgeons started to perform drainage of pancreatic cysts connecting to the Wirsung's duct during endoscopic retrograde cholangiopancreatography (ECPW) (6,7). A development of this technique is the currently performed cyst marsupialization to the gastrointestinal tract and fixation of the anastomosis site using a pig tail drain (8)(9)(10). The procedure is rapid and safe, and the use of endoscopic ultrasound helps to select a safe site for the anastomosis.…”

Section: Discussionmentioning

confidence: 99%

Multiple orifices are better than single in the endoscopic treatment of pancreatic pseudocysts

Miłek

Ciostek²,

Kielar³

et al. 2014

Turk J Gastroenterol

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Background/Aims: The aim of this study was to compare the surgical drainage of large, symptomatic pancreatic cysts (>5 cm) with single-and multi-channel endoscopic drainage. Materials and Methods: In the period 2005-2010, we treated 112 patients with post-inflammatory pancreatic cysts. Thirty-six patients underwent surgical internal drainage. The remaining group of patients was treated endoscopically. In 28 of them, drainage was performed by anastomosing the cyst to the gastrointestinal tract using a single pig tail drain and then widening the channel to a diameter of 15 mm. Forty-eight patients underwent multi-channel cystic drainage. It consisted of connecting the cyst to the stomach and/or duodenum using at least 3 drains. Each connection was widened to a minimum diameter of 15 mm to ensure free drainage of the morphotic elements of the cyst. Each procedure was preceded by abdominal computed tomography to determine the exact location of the cyst in relation to the gastrointestinal tract and a Doppler ultrasound scan to determine the location of the blood vessels modeling on its surface. Results: In 48 patients with multi-channel drainage, there was no obstruction of the anastomosis, and cysts closed within 4 months. The drains were removed after about 3 months. The created channels were patent for about 3-4 weeks, which was enough to completely close the cyst. Conclusion: Multi-channel endoscopic anastomosis of pancreatic cyst to the gastrointestinal tract is a very effective method for drainage of large post-inflammatory pancreatic cysts, comparable in terms of effectiveness with the surgical method but less invasive.

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“…[27][28][29] Recently, most of the tertiary care centres have adopted the endoscopic approach for PFC drainage. 20,30 EUS-guided transmural drainage has become standard treatment and compares favourably to surgical cystogastrostomy in terms of efficacy, morbidity/ mortality, the length of hospitalization and cost-effectiveness. 31,32 It is therefore nowadays the first-line treatment for drainage of mature pancreatic pseudocysts in close proximity to the gastric or duodenal wall.…”

Section: Eus-guided Transmural Drainage Of Pfcsmentioning

confidence: 99%

“…Clinical success rates of 70% to 87% have been reported in multiple studies, with complication rates of 11% to 34%. 30,[33][34][35] Drainage of more complex collections (acute necrotic collections [ANC], WOPN) can also be achieved surgically, via the percutaneous route, as well as endoscopically. There is controversy in the approach to these complex types of PFCs containing variable amounts of necrotic debris and this is reflected in the most recent consensus guidance from the International Association of Pancreatology (IAP) and the American Pancreatic Association (APA).…”

Section: Eus-guided Transmural Drainage Of Pfcsmentioning

confidence: 99%

Endoscopic ultrasound-guided extraluminal drainage: Novel concepts, challenges and future directions

Madácsy

Kaltsidis²

2017

Int J Gastrointest Interv

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A B S T R A C TEndoscopic ultrasound (EUS)-guided management of abdominal fluid collections adjacent to the gastroduodenal lumen is a relatively new concept attracting a lot of interest in recent years. The ability of EUS to identify and drain these collections in the same session accounts for the surge of interest in these novel techniques. On the other hand, the complexity of these interventions and associated serious complications has moderated the enthusiasm of novice endoscopists to some extent and reiterated that focused research and technical innovations are needed to make EUS-guided drainage simpler and safer. Self-expandable metallic stents (SEMS) have emerged in the last decade in the endoscopic management of malignant luminal gastrointestinal strictures. The use of SEMS in the management of benign conditions (biliary, pancreatic, and colonic strictures) is also rapidly expanding. Recently, fully-covered (FC)-SEMS have been successfully used for drainage of peripancreatic and pericholecystic fluid collections. Here we will review the existing data and future directions in the use of FC-SEMS for such drainage procedures. We will also review the literature on novel "purpose-made" prostheses, such as the lumen-apposing metallic stents, which aim to address technical problems arising in EUS-guided drainage procedures when conventional SEMS are used. Further development of these and other similar devices may transform EUS-guided drainage procedures from an esoteric concept to "mainstream", first-line intervention.

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Transpapillary and transmural drainage of pancreatic pseudocysts

Cited by 313 publications

References 12 publications

Laparoscopic Transgastric versus Endoscopic Drainage of a Large Pancreatic Pseudocyst. A Case Report

Laparoscopic Transgastric versus Endoscopic Drainage of a Large Pancreatic Pseudocyst. A Case Report

Multiple orifices are better than single in the endoscopic treatment of pancreatic pseudocysts

Endoscopic ultrasound-guided extraluminal drainage: Novel concepts, challenges and future directions

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