Use of a novel transluminal balloon accessotome in transmural drainage of pancreatic pseudocyst (with video).
BACKGROUND
Endoscopic transmural pseudocyst drainage is a multistep procedure.


OBJECTIVE
Our purpose was evaluation of a new device, the transluminal balloon accessotome (TBA) in transmural drainage of pancreatic pseudocysts.


METHODS
Case series.


METHODS
Subspecialty tertiary care center.


METHODS
Between September and October 2007, all consecutive patients with symptomatic pancreatic pseudocysts in whom TBA was used for pseudocyst drainage were included. Through a therapeutic duodenoscope, the pseudocyst was punctured with the needle-knife of the TBA at the point of maximal bulge. After the cyst cavity was entered, the needle-knife and the handle of the TBA device were withdrawn and a 0.035-inch guidewire was passed into the cavity. The tract was dilated with the inflatable balloon of the TBA device, and a 10F double-pigtail was inserted.


RESULTS
Six patients, all male, median age 35 years, underwent transmural pancreatic pseudocyst drainage with TBA during this period. All procedures were completed successfully. There were no major complications during or after the procedure except for fever in 1 patient, which responded to parenteral antibiotics. At 6-week follow-up, the pseudocyst cavity had completely collapsed, and stents could be extracted in all patients.


CONCLUSIONS
Single-center experience, small sample size.


CONCLUSIONS
TBA is a safe, useful, and easy-to-use device for transmural drainage of pancreatic pseudocysts.
Reddy
D Nageshwar
DN
Department of Medical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India.
Gupta
Rajesh
R
Lakhtakia
Sandeep
S
Jalal
Prasun K
PK
Rao
G Venkat
GV
D000293:Adolescent; D000328:Adult; D002404:Catheterization / Q000295:instrumentation*; D015331:Cohort Studies; D004322:Drainage / Q000295:instrumentation*; D016145:Endoscopy, Digestive System / Q000379:methods*; D019160:Endosonography / Q000379:methods; D004867:Equipment Design; D004869:Equipment Safety; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods; D010192:Pancreatic Pseudocyst / Q000000981:diagnostic imaging / Q000601:surgery*; D018570:Risk Assessment; D016896:Treatment Outcome