Single-step EUS-guided endoscopic treatment for sterile pancreatic collections: a single-center experience.
OBJECTIVE
Endoscopic ultrasound (EUS) is useful for the treatment of sterile pancreatic fluid collections (PFC), either by means of transmural drainage or by complete aspiration. The aim of this study was to evaluate the efficacy and safety of single-step EUS-guided endoscopic approaches for treatment of sterile PFC.


METHODS
During a 3-year period, 77 consecutive patients with symptomatic, persistent sterile PFC were evaluated and treated with the linear EUS. We excluded patients with grossly purulent collections, chronic pseudocyst and those whose cytology diagnostic was neoplastic cyst of pancreas. 44 patients received a single 10-Fr plastic straight stent under EUS or fluoroscopic control (group I) and 33 of these underwent a single-step complete aspiration with a 19-gauge needle (group II).


RESULTS
The mean size of the sterile PFC was 48 mm in group I and 28 mm in group II (p < 0.001). Overall, endoscopic treatment was successful in 70 (90.9%) patients. The mean volume aspirated was 25 (18-65) ml. The total number of procedures was 50 in group I and 41 punctures in group II. After a mean follow-up of 64 +/- 15.6 weeks there were 6 complications (13.6%): 2 recurrences (referred to surgery), 2 developing abscesses (submitted a new EUS-guided endoscopic drainage with success), 1 perforation that died (2.2%), and 1 case of bleeding (sent to surgery) in group I. In group II there were only 6 (18.1%) recurrences (submitted a new EUS-guided aspiration). None of the patients undergoing single-step aspiration developed infections, perforation or hemorrhage.


CONCLUSIONS
The recurrence of pancreatic pseudocysts after endoscopic treatment was similar, either by means of plastic stents or by complete single-step aspiration.
Ardengh
José C
JC
Endoscopic Unit of Ribeirão Preto Medical School, Hospital das Clínicas/USP, and Endoscopic Unit of 9 de Julho Hospital, São Paulo, Brazil. jcelso@uol.com.br
Coelho
Djalma E
DE
Coelho
José F
JF
de Lima
Luiz F Pereira
LF
dos Santos
José S
JS
Módena
José L Pimenta
JL
D000038:Abscess / Q000000981:diagnostic imaging; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003710:Demography; D019160:Endosonography / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D010192:Pancreatic Pseudocyst / Q000000981:diagnostic imaging* / Q000517:prevention & control / Q000628:therapy*; D012008:Recurrence