Endoscopic ultrasound-guided drainage of pancreatic fluid collections in children.
OBJECTIVE
Although endoscopic ultrasound (EUS)-guided drainage of pancreatic fluid collections (PFCs) has evolved as the standard of care in adults, its role as a single-step drainage modality in children is unclear. The aim of the present study was to evaluate the efficacy and safety of single-step EUS-guided drainage of PFCs in children.


METHODS
This is a retrospective study of all of the children who underwent single-step EUS-guided drainage of PFCs during a 4-year period at 1 institution. An endoscopic retrograde cholangiopancreatography was attempted before EUS-guided drainage to evaluate the pancreatic duct and bridge any ductal disruption.


RESULTS
A total of 7 children (4 boys; mean age 8.4 years [standard deviation 2.1]) underwent EUS-guided drainage of PFCs. The etiology was blunt abdominal trauma in 5, hereditary pancreatitis in 1, and idiopathic pancreatitis in 1. Both technical and treatment success rates were 100% with median procedural duration of 12 minutes (interquartile range 12-20 minutes). Two patients underwent repeat EUS-guided drainage due to lack of adequate resolution of PFC on follow-up computed tomography. There were no immediate or delayed complications. At a median follow-up of 1033 days (interquartile range 193-1167 days), all of the children were doing well with no PFC recurrence.


CONCLUSIONS
Single-step EUS-guided drainage of PFC in children is technically feasible, safe, clinically effective, and when available, should be the first-line treatment modality.
Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, Alabama 35294, USA. j1ramesh@gmail.com
Jayapal
J
Ramesh
Ji Y
JY
Bang
Jessica
J
Trevino
Shyam
S
Varadarajulu
D000007:Abdominal Injuries / Q000000981:diagnostic imaging / Q000628:therapy*; D002648:Child; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods; D004322:Drainage; D019160:Endosonography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D010179:Pancreas / Q000000981:diagnostic imaging; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging; D010189:Pancreatic Juice; D010195:Pancreatitis / Q000000981:diagnostic imaging / Q000628:therapy*; D050500:Pancreatitis, Chronic / Q000000981:diagnostic imaging / Q000628:therapy; D012189:Retrospective Studies; D016896:Treatment Outcome