Endoscopic pancreatic duct drainage and stenting for acute pancreatitis and pancreatic cyst and abscess.
OBJECTIVE
Endoscopic drainage of pancreatic pseudocysts using transpapillary and transmural approaches has been reported. In this study, endoscopic nasopancreatic drainage (ENPD) and pancreatic stenting were performed in patients with pseudocyst and abscess associated with acute pancreatitis, and the usefulness and problems of the procedures were investigated.


METHODS
After endoscopic retrograde pancreatography was done, ENPD and/or pancreatic stenting were performed in 13 patients with pancreatitis and pseudocyst or abscess that communicated with the main pancreatic duct.


RESULTS
ENPD was performed in seven patients, and was effective in all five patients with cysts: the cysts disappeared or shrank. However, the condition in the two patients with abscess was unchanged, and percutaneous drainage was performed. Stenting was carried out in six patients, and the cyst disappeared or pancreatitis was improved in all six. The stent was removed from two patients, but no recurrence has been noted so far.


CONCLUSIONS
ENPD and stenting are effective therapeutic choices for acute and chronic pancreatitis and pseudocysts, and they are superior to percutaneous drainage to avoid pancreatic fistula, but they may not be effective for pancreatic abscess. Selection of therapeutic methods corresponding to individual cases is important.
Shinozuka
Nozomi
N
Department of Surgery, Saitama Medical School, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan.
Okada
Katsuya
K
Torii
Takahiro
T
Hirooka
Eiji
E
Tabuchi
Satoshi
S
Aikawa
Kimiyasu
K
Tawara
Hideyuki
H
Ozawa
Shutaro
S
Ogawa
Nobuji
N
Miyazawa
Mitsuo
M
Takeda
Akihiko
A
Otani
Yoshihide
Y
Koyama
Isamu
I
D000038:Abscess / Q000000981:diagnostic imaging / Q000628:therapy*; D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D004322:Drainage / Q000379:methods*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D010192:Pancreatic Pseudocyst / Q000000981:diagnostic imaging / Q000628:therapy*; D010195:Pancreatitis / Q000000981:diagnostic imaging / Q000628:therapy*; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome