Endoscopic methods of internal drainage of pancreatic pseudocysts.

Abstract

Background: A steady increase in the incidence of chronic pancreatitis and its complications has been registered over the decade. Application of EUS-guided drainage has improved the results of treatment of this group of patients. Methods: In the period from 2007 to December 2016, 263 patients were treated for chronic pancreatitis at Botkin Clinical hospital, 211 of which were operated in the HPB department of the hospital. All the patients underwent ultrasound examination, CT with oral and intravenous contrasting, MRCP, tumor marker analysis. In questionable tumor cases an EUS examination was conducted with fine needle biopsy. The patients’ age averaged 51 (20 to 70 years old), with 211 male (80.2%) and 52 female patients (19.8%). Internal EUS-guided drainage of pseudocysts was performed in 28 cases. The average size of the cysts was 55 ± 65 mm. In 18 cases (8.5%) a nitinol stenting was performed, in 10 cases (4.7%) – a double-pigtail stenting was performed. Stents were removed 4-6 weeks after the introduction depending on the control CT results. Results: The clinical effect was obtained in 100% of the cases. Complications were diagnosed in 2 patients who had plastic stents (cyst recurrence, abscess) and in one patient with a nitinol stent (stent dislocation). No cases of mortality were registered. Conclusion: The employment of EUS-guided drainage of the pancreatic pseudocysts can improve treatment results and helps avoid major surgical procedures in such cases.