Transmural drainage of pancreatic fluid collections without electrocautery using the Seldinger technique.
BACKGROUND
Complications of endoscopic transmural drainage of pancreatic fluid collections arise from entry through the gastrointestinal wall. We describe transmural drainage of these collections using the Seldinger technique without electrocautery.


METHODS
From January 1995 to September 1997, we attempted endoscopic transmural drainage of 94 consecutive pancreatic fluid collections without EUS guidance (needle-knife entry in 51, Seldinger entry technique in 43). Success of entry and complications were compared.


RESULTS
Successful entry was achieved in 95.3% using the Seldinger technique and 92.1% using the needle-knife entry technique (p = NS). Complications of bleeding and perforation were seen in 4.6% of patients in the Seldinger group and 15.7% in the needle-knife entry group.


CONCLUSIONS
The Seldinger technique of endoscopic transmural drainage of pancreatic fluid collections appears effective and safer than entry using the needle-knife. Collections as small as 3 cm in diameter can be entered using the Seldinger technique without EUS guidance.
Department of Radiology, University of Alabama, Birmingham 35294, USA.
K E
KE
Mönkemüller
T H
TH
Baron
D E
DE
Morgan
D016009:Chi-Square Distribution; D004322:Drainage / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D004564:Electrocoagulation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D019723:Endoscopes; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D005069:Evaluation Studies as Topic; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D008875:Middle Aged; D010192:Pancreatic Pseudocyst / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D015607:Stents; D016896:Treatment Outcome