title: Endoscopic drainage of pancreatic fluid collections: Long-term outcomes in children.
abstract: OBJECTIVE
  Endoscopic drainage of pancreatic fluid collections (PFC) is the standard of care in adult patients. The literature is limited in children. In the present study, we aim to evaluate the safety and long-term efficacy of endoscopic ultrasound (EUS)-guided drainage of PFC in children.
  
  
  METHODS
  Data of all children (<18 years) with PFC who underwent EUS-guided drainage with plastic stents were analyzed retrospectively for technical feasibility, clinical efficacy and adverse events (AE).
  
  
  RESULTS
  Thirty children (boys 22, girls 8) with PFC underwent EUS drainage (January 2013 to June 2016). Mean age of children was 13.07 ± 3.41 years (5-17 years). Majority of children had idiopathic pancreatitis (23), followed by trauma-related (6) and gallstone-related pancreatitis (1). Of 30 PFC, 13 (43.3%) and 17 (56.7%) were classified as pseudocyst and walled-off necrosis, respectively. Median size of PFC was 95 mm (61-175). EUS drainage was successfully completed in 29 children (technical success 96.7%). Clinical success was achieved in 28/30 (93.3%) children. AE included perforation (2), major bleed (1), minor bleed (2), stent migration (4) and readmission as a result of hematemesis (1). Imaging revealed disconnected pancreatic duct in nine, ductal leak in two and stricture in one child. Cystogastric stents were left in situ in children with disconnected duct. At median follow up of 829 days (150-1230), two recurrences of PFC were noticed.
  
  
  CONCLUSIONS
  EUS-guided drainage using plastic stents is safe and effective in children with PFC. Cystogastric plastic stents can be left safely long term. However, more studies with larger sample sizes are required.
authors.affiliation: Asian Institute of Gastroenterology, Hyderabad, India.
authors.forename: Zaheer
authors.identifier: http://orcid.org/0000-0003-2713-4781
authors.initials: Z
authors.lastname: Nabi
authors.affiliation: Asian Institute of Gastroenterology, Hyderabad, India.
authors.forename: Sundeep
authors.identifier: http://orcid.org/0000-0001-7562-8060
authors.initials: S
authors.lastname: Lakhtakia
authors.affiliation: Asian Institute of Gastroenterology, Hyderabad, India.
authors.forename: Jahangeer
authors.initials: J
authors.lastname: Basha
authors.affiliation: Asian Institute of Gastroenterology, Hyderabad, India.
authors.forename: Radhika
authors.initials: R
authors.lastname: Chavan
authors.affiliation: Asian Institute of Gastroenterology, Hyderabad, India.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Gupta
authors.affiliation: Asian Institute of Gastroenterology, Hyderabad, India.
authors.forename: Mohan
authors.initials: M
authors.lastname: Ramchandani
authors.affiliation: Asian Institute of Gastroenterology, Hyderabad, India.
authors.forename: Rakesh
authors.initials: R
authors.lastname: Kalapala
authors.affiliation: Asian Institute of Gastroenterology, Hyderabad, India.
authors.forename: Partha
authors.initials: P
authors.lastname: Pal
authors.affiliation: Asian Institute of Gastroenterology, Hyderabad, India.
authors.forename: Santosh
authors.initials: S
authors.lastname: Darisetty
authors.affiliation: Asian Institute of Gastroenterology, Hyderabad, India.
authors.forename: Guduru Venkat
authors.initials: GV
authors.lastname: Rao
authors.affiliation: Asian Institute of Gastroenterology, Hyderabad, India.
authors.forename: D
authors.initials: D
authors.lastname: Nageshwar Reddy
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000367:Age Factors; D019072:Antibiotic Prophylaxis / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004322:Drainage / Q000379:methods*; D019160:Endosonography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010189:Pancreatic Juice; D010195:Pancreatitis / Q000175:diagnosis* / Q000601:surgery; D061214:Patient Safety; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome
keywords: child; collection; drainage; endoscopic ultrasonography; pancreatitis