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Asociación Mexicana de Gastroenterología

2005, Number 3

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Rev Gastroenterol Mex 2005; 70 (3)

Transpapillary and transmural drainage of pancreatic pseudocysts

Güitrón-Cantú A, Adalid-Martínez R, Gutiérrez-Bermúdez JA

Language: Spanish
References: 30
Page: 240-246
PDF size: 63.46 Kb.


ABSTRACT

Background: Endoscopic treatment of pancreatic pseudocysts via cystoenterostomy or transpapillary stenting has been recognized as a successful treatment options in carefully selected patients. Transpapillary stenting is an option in patients with pancreatic pseudocysts directly communicating with the main duct. Aim: The aim of this study was to assess the safety and usefulness of transpapillary pancreatic endoprosthesis and transmural drainage in the treatment of symptomatic pancreatic pseudocysts. Patients and methods: After preliminary endoscopic retrograde pancreatography (ERCP) in 22 patients, transpapillary drainage was attempted in 8 patients with pseudocysts that communicated with the main pancreatic duct, transmural drainage of pseudocysts in contact with the stomach or duodenal wall was attempted in 12 patients and 2 patients were selected for combined transpapillary and transmural drainage. Results: Endoscopic drainage was technically successful in 18 patients (81.8%) of whom 16 had complete pseudocyst resolution. Complications occurred in 9 % and included bleeding (n = 1) after transmural drainage, and pancreatitis (n = 1) after transpapillary drainage. Mean follow-up was 12 months (range, 2 to 21); pseudocysts recurred in 2 patients (11%), whom required surgical intervention. No mortality was observed. Conclusion: Both transpapillary and transmural pseudocysts drainage are highly effective in patients with pseudocysts demonstrating suitable anatomy for these endoscopic techniques.


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