title: Intracystic wire exchange facilitating insertion of multiple stents during endoscopic drainage of pancreatic pseudocysts.
abstract: BACKGROUND
  Endoscopic drainage of pancreatic pseudocysts and abscesses has been shown to be an effective treatment modality. A major determinant for successful cyst resolution is the insertion of multiple endoprostheses and/or placement of a nasocystic drain, which require repeated entries of a catheter into the pseudocyst to reintroduce the guidewire.
  
  
  OBJECTIVE
  We describe a novel and easy technique to prevent the need for repeated access into the pseudocyst, thereby facilitating the placement of multiple endoprostheses by using a commercially available guiding system for stent introduction.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Academic Medical Center, The Netherlands.
  
  
  METHODS
  Eight consecutive patients with symptomatic pancreatic pseudocysts after acute pancreatitis.
  
  
  METHODS
  Intracystic wire exchange for the insertion of multiple stents in endoscopic treatment of pancreatic pseudocysts by using an echoendoscope.
  
  
  METHODS
  Feasibility of intracystic wire exchange and complications.
  
  
  RESULTS
  No guidewire access to the pseudocyst was lost. The procedure was well tolerated by the patients. Complete pseudocyst resolution was established in all patients.
  
  
  CONCLUSIONS
  The endoscopic appliance of multiple stents becomes easier when using intracystic wire exchange for transgastric pancreatic pseudocyst drainage.
authors.affiliation: Department of Gastroenterology and Hepatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Jeroen M
authors.initials: JM
authors.lastname: Jansen
authors.forename: Agaath
authors.initials: A
authors.lastname: Hanrath
authors.forename: Eric A
authors.initials: EA
authors.lastname: Rauws
authors.forename: Marco J
authors.initials: MJ
authors.lastname: Bruno
authors.forename: Paul
authors.initials: P
authors.lastname: Fockens
mesh_terms: D000328:Adult; D004322:Drainage; D016145:Endoscopy, Digestive System / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010192:Pancreatic Pseudocyst / Q000473:pathology / Q000601:surgery*; D019919:Prosthesis Implantation / Q000379:methods*; D015607:Stents