title: Successful Resolution of Gastric Outlet Obstruction Caused by Pancreatic Pseudocyst or Walled-Off Necrosis After Acute Pancreatitis: The Role of Percutaneous Catheter Drainage.
abstract: OBJECTIVE
  Delayed gastric emptying (DGE) in patients with acute pancreatitis (AP) can be caused by gastroparesis or gastric outlet obstruction, which may occur when pancreatic pseudocyst (PP) or walled-off necrosis (WON) compresses the stomach. The aim of the study was to explore a proper surgical treatment.
  
  
  METHODS
  From June 2010 to June 2013, 25 of 148 patients with AP suffered DGE. Among them, 12 were caused by gastroparesis, 1 was a result of obstruction from a Candida albicans plug, and 12 were gastric outlet obstruction (GOO) compressed by PP (n = 8) or WON (n = 4), which were treated by percutaneous catheter drainage (PCD).
  
  
  RESULTS
  All 12 cases of compressing GOO achieved resolution by PCD after 6 [1.86] and 37.25 [12.02] days for PP and WON, respectively. Five cases developed intracystic infection, 3 cases had pancreatic fistulae whereas 2 achieved resolution and 1 underwent a pseudocyst jejunostomy.
  
  
  CONCLUSIONS
  Gastric outlet obstruction caused by a PP or WON is a major cause of DGE in patients with AP. Percutaneous catheter drainage with multiple sites, large-bore tubing, and lavage may be a good therapy due to high safety and minimal invasiveness.
authors.affiliation: From the *The Department of Hepatobiliary and Pancreatic Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine; and †The Women's Hospital Affiliated to Medical College of Zhejiang University, Hangzhou, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Zhang
authors.forename: Shao-Yang
authors.initials: SY
authors.lastname: Zhang
authors.forename: Shun-Liang
authors.initials: SL
authors.lastname: Gao
authors.forename: Zhong-Yan
authors.initials: ZY
authors.lastname: Liang
authors.forename: Wen-Qiao
authors.initials: WQ
authors.lastname: Yu
authors.forename: Ting-Bo
authors.initials: TB
authors.lastname: Liang
mesh_terms: D000208:Acute Disease; D057785:Catheters; D004322:Drainage / Q000009:adverse effects / Q000379:methods*; D005746:Gastric Emptying; D017219:Gastric Outlet Obstruction / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D018589:Gastroparesis / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D007582:Jejunostomy; D009336:Necrosis / Q000150:complications; D010185:Pancreatic Fistula / Q000209:etiology / Q000601:surgery; D010192:Pancreatic Pseudocyst / Q000150:complications*; D010195:Pancreatitis / Q000150:complications*; D016896:Treatment Outcome