Cystogastrotomy entirely performed under endosonography guidance for pancreatic pseudocyst: results in six patients.
BACKGROUND
There are increasing reports of endoscopic drainage of pancreatic pseudocysts. Endoscopic ultrasound (EUS) has been recommended for optimal localization of the puncture site and to reduce the risk of bleeding and perforation. We describe our experience with cystogastrostomy guided entirely by EUS.


METHODS
EUS-guided cystogastrostomy was performed in six patients. No patient had an endoscopically visible bulge on the gastric wall; gastric varices were evident in one patient. Mean pseudocyst diameter was 4.5 cm (pancreatic body 2, tail 4).


RESULTS
Pseudocyst puncture was successful on one pass in five patients; a nasocystic drain was placed in five, a stent in one. Mean follow-up was 8 months; the pseudocyst reoccurred in only one patient in whom the stent had clogged. There were no complications.


CONCLUSIONS
EUS-guided drainage of pseudocysts is accurate and can be performed even if the cyst does not produce an endoscopically visible bulge. It may reduce the risk of complications.
Endoscopic Unit, Paoli-Calmettes Institute, Marseilles, France.
M
M
Giovannini
D
D
Bernardini
J F
JF
Seitz
D000328:Adult; D004322:Drainage / Q000295:instrumentation / Q000379:methods; D019723:Endoscopes; D004724:Endoscopy / Q000379:methods*; D019160:Endosonography / Q000295:instrumentation / Q000379:methods; D005069:Evaluation Studies as Topic; D005260:Female; D005774:Gastrostomy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging* / Q000601:surgery*; D010192:Pancreatic Pseudocyst / Q000000981:diagnostic imaging* / Q000601:surgery*; D011677:Punctures / Q000295:instrumentation / Q000379:methods; D014159:Transducers; D018084:Ultrasonography, Interventional / Q000295:instrumentation / Q000379:methods