Sa1578 Predictors of Surgical Resection in Patients With Pancreatic Cystic Lesions Undergoing Endoscopic Ultrasound With and Without Fine Needle Aspiration

Abstract

bloody aspiration, n 1; EUS-guided imaging only through meshes of an intestinal stent, n 1); ii) drainage, n 57 (81.4%; metal stent, n 41/57; 71.9%// polyethylene stent, n 16/57; 28.1%) / long-term drainage (clinical success): mean, 8 (range, 2-18) months in malignancy. The spectrum of various approaches to place the drainage (n 57) comprised: i) rendezvous, n 8/14%; ii) antegrade-intrahepatic, n 3/5.3%; iii) retrograde-intrahepatic, n 35/61.4%; iv) antegrade-extrahepatic, n 9/15.8%; v) antegrade-retrograde, n 2/3.5%. Causes for not possible drainage comprised: i) Dilatation problems at the access site, n 5; ii) frustrating rendesvouz technique, n 2; iii) stent dislocation into abdominal cavity (endoscopic removal achieved), n 3; iv) frustrating placement through the meshes of an intestinal stent, n 2; v) blood aspiration, n 1; vi) failure of fluoroscopy, n 1). Complication profile contented cholangitis (n 3), stent dislocation (n 5; n 1 in mid-term run), postinterventional pain (n 2) & hemobilia (n 1). Reintervention became necessary in 3/70 (4.3%). Conclusion: EUCD (favoring rendesvouz technique) is a feasible & safe alternative treatment option with an acceptable periinterventional risk in selected patients preferentially with advanced & metastasized tumor growth, which aims for an improvement of the quality of life under palliative intention avoiding mostly a reintervention, which has to be still considered an experimental clinical procedure to be only performed in centres with great expertise in interventional endoscopy/EUS but i) broadens the therapeutic spectrum & ii) needs further study-based investigation.