title: Clinicopathologic characteristics and endoscopic treatment of post-traumatic pancreatic pseudocysts.
abstract: OBJECTIVE
  Surgery is the treatment of choice for traumatic pseudocyst. Minimally invasive management of these collections has been used. The aim was to analyze the outcome after endoscopic treatment and the integrity of the main pancreatic duct caused by abdominal trauma.
  
  
  METHODS
  A total of 51 patients with traumatic pseudocyst who underwent endoscopic therapy were studied. All were symptomatic with a persistent collection for more than 6 weeks. Endoscopic retrograde pancreatography allowed characterization according to Takishima classification (1, 2, and 3), in which guided therapy was divided into transpapillary drainage (Takishima 2 and 3 without bulging), transmural (type 1), or combined (type 2 or 3 with bulging).
  
  
  RESULTS
  Endoscopic retrograde pancreatography was obtained in 47 (90%) of 51 patients. Drainage was transmural in 13, combined in 24, and transpapillary in 10. The success and recurrence rates of endoscopic treatment were 94% and 8%, respectively. There were 9 complications but no procedure-related deaths. Patients with penetrating trauma had more recurrences (P = 0.01) and risk for development of infection (P = 0.045) than those with blunt trauma.
  
  
  CONCLUSIONS
  Endoscopic treatment of traumatic pancreatic collection is safe and effective and can be considered a first-choice alternative to surgical treatment. Endoscopic retrograde pancreatography and Takishima classification are useful in determining the best endoscopic approach.
authors.affiliation: Department of Surgery, Universidade Estácio de Sá, Rio de Janeiro, Brazil.
authors.forename: Djalma Ernesto
authors.initials: DE
authors.lastname: Coelho
authors.forename: José Celso
authors.initials: JC
authors.lastname: Ardengh
authors.forename: Mariana Teixeira
authors.initials: MT
authors.lastname: Carbalo
authors.forename: Eder Rios
authors.initials: ER
authors.lastname: de Lima-Filho
authors.forename: Todd H
authors.initials: TH
authors.lastname: Baron
authors.forename: José Flávio
authors.initials: JF
authors.lastname: Coelho
mesh_terms: D000328:Adult; D002760:Cholangiopancreatography, Endoscopic Retrograde; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D010179:Pancreas / Q000293:injuries*; D010183:Pancreatic Ducts / Q000601:surgery; D010192:Pancreatic Pseudocyst / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D012008:Recurrence; D015607:Stents; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000150:complications; D055815:Young Adult