Background: Pancreatic pseudocyst endoscopic drainage
has been described as a good treatment option,
with morbidity and mortality rates that are lower
than surgery. The aim of our study is to describe the
efficacy of different forms of endoscopic drainage
and estimate pseudocyst recurrence rate after short
follow up period.
Patients and Methods: We studied 30 patients with
pancreatic pseudocyst that presented some indication
for treatment: persistent abdominal pain, infection
or cholestasis. Clinical evaluation was performed
with a pain scale, 0 meaning absence of pain
and 4 meaning continuous pain. Pseudocysts were
first evaluated by abdominal CT scan, and after
endoscopic retrograde pancreatography the patients
were treated by transpapillary or transmural (cystduodenostomy
or cystgastrostomy) drainage. Pseudocyst
resolution was documented by serial CT
scans.
Results: 25/30 patients could be treated. Drainage
was successful in 21 (70% in an ‘intention to treat’
basis). After a mean follow-up of 42±35.82 weeks,
there was only 1 (4.2%) recurrence. A total of 6 complications
occurred in 37 procedures (16.2%), and all
but 2 were managed clinically and/or endoscopically:
there was no mortality related to the procedure.
Patients submitted to combined drainage
needed more procedures than the other groups.
There was no difference in the efficacy when we
compared the three different drainage methods.
Conclusions: We concluded that pancreatic pseudocyst
endoscopic drainage is possible in most
patients, with high success rate and low morbidity.
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