Endoscopic cystogastrostomy: Still a viable option in children with symptomatic pancreatic fluid collection

Poddar, Ujjal; Yachha, Surender Kumar; Upadhyaya, Vijai Datta; Kumar, Basant; Borkar, Vibhor; Malik, Rohan; Srivastava, Anshu

doi:10.1016/j.pan.2021.02.004

Cited by 4 publications

(10 citation statements)

References 36 publications

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“…After screening for eligibility, a total of 14 studies were included in this review. The included studies were published as full-text (10) or abstracts (4) between 2008 and 2021 [ 15 16 17 18 19 20 21 22 23 24 25 26 27 28 ]. All the included studies were retrospective in nature.…”

Section: Resultsmentioning

confidence: 99%

“…Overall, the studies involved a total of 187 children with a pooled mean age of 11.7 years (95% CI, 10.2–13.2 years). The aetiology of pancreatitis was described in nine studies (137 children), and were idiopathic in 76 (55.5%), trauma in 32 (23.3%), biliary in 13 (9.5%), chronic pancreatitis in 5 (3.6%), pancreas divisum in 3 (2.2%), genetics in 3 (2.2%), and others in 5 (3.6%) children [ 15 16 17 20 21 22 23 24 27 ]. The characteristics of fluid collection in 13 studies were pseudocysts in 108 (60.3%) and walled-off necrosis (WON) in 71 (39.7%).…”

Section: Resultsmentioning

confidence: 99%

“…Endoscopic drainage procedures were performed under general anesthesia in four studies [ 16 17 20 21 ]. Moderate sedation (ketamine, midazolam, or diazepam with or without propofol) was used in five studies [ 15 18 22 23 27 ] ( Supplementary Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…Endoscopic drainage of PFCs was performed under EUS guidance in 10 studies [ 18 19 20 21 22 23 24 25 26 28 ] and without EUS guidance in three studies [ 15 17 27 ]. In one study, drainage procedures were performed using both techniques [ 16 ].…”

Section: Resultsmentioning

confidence: 99%

“…The type of stent used for endoscopic transmural drainage was reported in 10 studies including one or more plastic stents in six studies [ 15 16 17 20 22 27 ], either plastic or metal stents in three studies [ 21 24 25 ], and exclusively metal stents in one study [ 23 ].…”

Section: Resultsmentioning

confidence: 99%

See 4 more Smart Citations

Outcomes of Endoscopic Drainage in Children with Pancreatic Fluid Collections: A Systematic Review and Meta-Analysis

Nabi

Talukdar

Lakhtakia

et al. 2022

Pediatr Gastroenterol Hepatol Nutr

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Purpose Endoscopic drainage is an established treatment modality for adult patients with pancreatic fluid collections (PFCs). Available data regarding the efficacy and safety of endoscopic drainage in pediatric patients are limited. In this systematic review and meta-analysis, we aimed to analyze the outcomes of endoscopic drainage in children with PFCs. Methods A literature search was performed in Embase, PubMed, and Google Scholar for studies on the outcomes of endoscopic drainage with or without endoscopic ultrasonography (EUS) guidance in pediatric patients with PFCs from inception to May 2021. The study’s primary objective was clinical success, defined as resolution of PFCs. The secondary outcomes included technical success, adverse events, and recurrence rates. Results Fourteen studies (187 children, 70.3% male) were included in this review. The subtypes of fluid collection included pseudocysts (60.3%) and walled-off necrosis (39.7%). The pooled technical success rates in studies where drainage of PFCs were performed with and without EUS guidance were 95.3% (95% confidence interval [CI], 89.6–98%; I 2 =0) and 93.9% (95% CI, 82.6–98%; I 2 =0), respectively. The pooled clinical success after one and two endoscopic interventions were 88.7% (95% CI, 82.7–92.9%; I 2 =0) and 92.3% (95% CI, 87.4–95.4%; I 2 =0), respectively. The pooled rate of major adverse events was 6.3% (95% CI, 3.3–11.4%; I 2 =0). The pooled rate of recurrent PFCs after endoscopic drainage was 10.4% (95% CI, 6.1–17.1%; I 2 =0). Conclusion Endoscopic drainage is safe and effective in children with PFCs. However, future studies are required to compare endoscopic and EUS-guided drainage of PFCs in children.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Outcomes of Endoscopic Drainage in Children with Pancreatic Fluid Collections: A Systematic Review and Meta-Analysis

Nabi

Talukdar

Lakhtakia

et al. 2022

Pediatr Gastroenterol Hepatol Nutr

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Recent progress and current status of pancreatobiliary interventional endoscopic ultrasound in children

Ishii,

Isayama,

Suzuki

et al. 2024

Digestive Endoscopy

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In recent years, the usefulness of endoscopic ultrasound (EUS) has been recognized in children. A dedicated pediatric EUS scope has not been developed; in our experience, however, an adult EUS scope can be used. The American Society for Gastrointestinal Endoscopy Technical Committee status assessment report on pediatric endoscopy equipment provides some guidance on the feasibility of EUS according to body size. Careful monitoring is required, keeping in mind potential adverse events such as cervical esophageal perforation and unstable breathing due to tracheal compression. Most devices designed for interventional pancreatobiliary endoscopy are also available for children. Sedation or intubated general anesthesia (GA) is mandatory when performing interventional EUS (I‐EUS). I‐EUS for children is generally performed using GA in the operating room, but sedation in the endoscopy room is also possible under appropriate monitoring by pediatricians. I‐EUS in the operating room is sometimes difficult for endoscopists to perform because of the unsuitable fluoroscopic imaging and the lack of familiar equipment and staff. Compared to GA, sedation in the endoscopy room facilitates easier and quicker repetition of procedures when necessary. Adult pancreatobiliary endoscopists perform most I‐EUS procedures in the pediatric population because most pediatric endoscopists have few opportunities to perform EUS‐related procedures and thus have difficulty maintaining their skills. To popularize I‐EUS techniques for children, it will be necessary to establish a training program for developing pediatric endoscopists.

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Endoscopic ultrasound-guided cystogastrostomy in the treatment of the complicated form of acute pancreatitis in children

Pavlushin¹,

Gramzin²,

Drobyazgin³

et al. 2023

Russian Journal of Pediatric Surgery, Anesthesia and Intensive

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Acute pancreatitis in children is relatively rare, about 3-13 cases per 100,000 population annually, and complicated forms are three times less common than in the adult cohort of patients. However, recently there has been an increase in the number of acute pancreatitis in the pediatric group, which entails a relatively higher incidence of complicated forms of acute pancreatitis, including the formation of parapancreatic acute fluid accumulations, and determines the relevance of this problem for pediatric surgeons. In this article, using the example of 2 observations, the technology of puncture of a parapancreatic pseudocyst under ultrasound and X-ray control is presented, followed by the introduction of a conductor string into the cavity of the pseudocyst and further stenting of this anastomosis with two plastic double-pigtail stents. In the first case, a 12-year-old boy was operated on with idiopathic pancreatitis and the formation of an acute parapancreatic fluid accumulation in the tail of the pancreas. In the second observation, in a 10-year-old girl, the formation of a parapancreatic pseudocyst occurred as a result of drug-induced pancreatitis (a complication of long-term use of the antiepileptic drug - valproic acid). Both children were operated on using this technique. Antisecretory therapy was carried out in the postoperative period. Catamnesis after 1 year and 6 months: children do not complain, ultrasound and x-ray studies did not reveal any pathology. Conclusion. Endoscopic cystogastrostomy under ultrasound guidance is a method that has found wide application in the complicated course of pancreatitis in adult patients. These observations show its effectiveness in pediatric practice. But the relatively short period of observation of treatment results requires additional research on a much larger number of outcomes of these surgical interventions in children.

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Endoscopic cystogastrostomy: Still a viable option in children with symptomatic pancreatic fluid collection

Cited by 4 publications

References 36 publications

Outcomes of Endoscopic Drainage in Children with Pancreatic Fluid Collections: A Systematic Review and Meta-Analysis

Outcomes of Endoscopic Drainage in Children with Pancreatic Fluid Collections: A Systematic Review and Meta-Analysis

Recent progress and current status of pancreatobiliary interventional endoscopic ultrasound in children

Endoscopic ultrasound-guided cystogastrostomy in the treatment of the complicated form of acute pancreatitis in children

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