[Transpapillary and transmural drainage of pancreatic pseudocysts].
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.


OBJECTIVE
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.


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.


CONCLUSIONS
Both transpapillary and transmural pseudocysts drainage are highly effective in patients with pseudocysts demonstrating suitable anatomy for these endoscopic techniques.
Güitrón-Cantú
Alfredo
A
Departamento de Endoscopia Digestiva, Hospital de Especialidades No. 71, Instituto Mexicano del Seguro Social Torreón, Coahuila.
Adalid-Martínez
Raúl
R
Gutiérrez-Bermúdez
José A
JA
D000293:Adolescent; D000328:Adult; D000368:Aged; D004322:Drainage / Q000379:methods*; D016145:Endoscopy, Digestive System; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts; D010192:Pancreatic Pseudocyst / Q000628:therapy*