The efficacy of endoscopic treatment of pancreatic pseudocysts

Smits, M.; Rauws, Erik A.; Tytgat, G. N. J.; Huibregtse, K.

doi:10.1016/s0016-5107(95)70092-7

Cited by 220 publications

(144 citation statements)

References 30 publications

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“…Several studies place the technical success of transmural drainage of pseudocyst at 85%-100%. The recurrence rate range from 10%-15% with complications between 10%-34% [63,[66][67][68] . In recent years, EUS-guided pseudocyst (EGPD) drainage has gained in popularity since it allow to avoid intervening vessels and target more challenging collections safely when compared to conventional transmural drainage Sauerbruch et al [107] 8 8 8 11 Den Toom et al [108] 8 8 (7 pain relief) 8 17 Sauerbruch et al [109] 24 24 24 24 Delhaye et al [60] 123 88 123 Schneider et al [110] 50 39 48 20 Van der Hul et al [111] 17 17 17 30 Wolf et al [112] 12 9 12 19-22 Schreiber et al [113] 10 7 10 12 Johanns et al [114] 35 23 16 NA Ohara et al [115] Uncovered metal stents have also been evaluated.…”

Section: Pancreatic Pseudocystsmentioning

confidence: 99%

Endoscopic management of chronic pancreatitis

Oza

Kahaleh²

2013

WJGE

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Chronic pancreatitis (CP) is a common gastrointestinal illness, which affects the quality of life with substantial morbidity and mortality. The management includes medical, endoscopic and surgical approaches with the need for interaction between various specialties, calling for a concerted multidisciplinary approach. However, at the time of this publication, guidelines to establish care of these patients are lacking. This review provides the reader with a comprehensive overview of the studies summarizing the various treatment options available, including medical, surgical and endoscopic options. In addition, technological advances such as endoscopic retrograde cholangiopancreatogrophy, endoscopic shock wave lithotripsy and endoscopic ultrasound can now be offered with reasonable success for pancreatic decompression, stricture dilatation with stent placement, stone fragmentation, pseudocyst drainage, and other endoscopic interventions such as celiac plexus block for pain relief. We emphasize the endoscopic options in this review, and attempt to extract the most up to date information from the current literature. The treatment of CP and its complications are discussed extensively. Complications such as biliary strictures. pancreatic pseudocysts, and chronic pain are common issues that arise as long-term complications of CP. These often require endoscopic or surgical management and possibly a combination of approaches, however choosing amongst the various therapeutic and palliative modalities while weighing the risks and benefits, makes the management of CP challenging. Treatment goals should be not just to control symptoms but also to prevent disease progression. Our aim in this paper is to advocate and emphasize an evidence based approach for the management of CP and associated long term complications.

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Section: Pancreatic Pseudocystsmentioning

confidence: 99%

Endoscopic management of chronic pancreatitis

Oza

Kahaleh²

2013

WJGE

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“…Haemorrhage depends on the presence of pericystic or peridigestive vessels, segmental portal hypertension and the haemorrhagic content of the cyst. Perforation depends on the distance between the digestive-wall and (Table 3) [48][49][50][51][52][53] . Mean rate of healing, failure and recurrence were respectively 78% (51%-82%), 5.5% (0%-16%) and 6.5% (3%-13%).…”

Section: Treatment Of Pancreatic Cysts and Pseudo Cystsmentioning

confidence: 99%

Endoscopic treatment of chronic pancreatitis

Heyries¹,

Sahel²

2007

WJG

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Treatment of chronic pancreatitis has been exclusively surgical for a long time. Recently, endoscopic therapy has become widely used as a primary therapeutic option. Initially performed for drainage of pancreatic cysts and pseudocysts, endoscopic treatments were adapted to biliary and pancreatic ducts stenosis. Pancreatic sphincterotomy which allows access to pancreatic ducts was firstly reported. Secondly, endoscopic methods of stenting, dilatation, and stones extraction of the bile ducts were applied to pancreatic ducts. Nevertheless, n e w i m p r o v e m e n t s w e r e n e c e s s a r y : f a i l u r e s o f pancreatic stone extraction justified the development of extra-corporeal shock wave lithotripsy; dilatation of pancreatic stenosis was improved by forage with a new device; moreover endosonography allowed guidance for celiac block, gastro-cystostomy, duodeno-cystostomy and pancreatico-gastrostomy. Although endoscopic treatments are more and more frequently accepted, indications are still debated. METHODSEndoscopic treatment needs a team (operator, anaesthesiologist) aware with Endoscopic Retrograde Cholangiopancreatography (ERCP) procedures. Specific material is necessary: good fluoroscopy with the possibility to magnify pictures, and a duodenoscope with a 4.2 channel allowing insertion of high calibre stent (10 Fr). Moreover, a wide variety of endoscopic ancillar y instruments is essential: metallic and hydrophilic guidewire, sphincterotomes, Dormia basket, balloon dilatators and bougie dilatators (5-11.5 Fr), but also very thin guide wire (0.025 inches), fine-tipped sphincterotomes, Soehendra extractors (cf infra) [1] . Impaction of stones in pancreatic ducts needs the use of extracorporeal shock wave lithotripsy before endoscopic stone extraction [2]

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“…Its predictive factors of success include the presence of strictured areas, the pseudocysts size over 6 cm in diameter, location in the body of the pancreas and an evolution of the pseudocyst of less than 6 months (29). As far as the procedure's safety is concerned, there is a low morbidity and no reported mortality in patients submitted to this maneuver (29,(31)(32)(33)(34)(35). Among possible complications, hemorrhage is reported in less than 1% of cases, postprocedural pancreatitis in 5% of cases while stent migration is considered extremely rare (29,(31)(32)(33)(34)(35).…”

Section: Introductionmentioning

confidence: 99%

“…As far as the procedure's safety is concerned, there is a low morbidity and no reported mortality in patients submitted to this maneuver (29,(31)(32)(33)(34)(35). Among possible complications, hemorrhage is reported in less than 1% of cases, postprocedural pancreatitis in 5% of cases while stent migration is considered extremely rare (29,(31)(32)(33)(34)(35). Some authors reported stent obstruction in secondary infections of the pseudocyst, in which case stent change alone may be the only necessary maneuver (29,34,35).…”

Section: Introductionmentioning

confidence: 99%

“…Among possible complications, hemorrhage is reported in less than 1% of cases, postprocedural pancreatitis in 5% of cases while stent migration is considered extremely rare (29,(31)(32)(33)(34)(35). Some authors reported stent obstruction in secondary infections of the pseudocyst, in which case stent change alone may be the only necessary maneuver (29,34,35). The presence of stents in the pancreatic duct is not without consequence, its sole presence leading to strictures similar to those seen in patients suffering from chronic pancreatitis (36,37).…”

Section: Introductionmentioning

confidence: 99%

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Therapeutical Aspects Regarding Pancreatic Pseudocysts

David¹,

Grigorean²

2018

chr

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Chirurgia, 113 (3), 2018 www.revistachirurgia.ro 353 RezumatFrecvent apărute că şi complicaţii ale pancreatitei, pseudochistele pancreatice sunt entităţi rare, pentru tratamentul cărora s-au dezvoltat de-a lungul timpului multiple tehnici terapeutice, variind de la metode minim invazive la tehnici complexe de chirurgie clasică. Pseudochistele simptomatice, cele de mari dimensiuni precum şi cele ce suferă complicaţii evolutive de timpul hemoragiei, suprainfectiei şi rupturii au indicaţie de drenaj. Alegerea metodei optime de drenaj este deseori o provocare, multiplii factori trebuind să fie luaţi în considerare, incluzând locaţia pseudochistului, dimensiunea precum şi starea generală a pacientului şi comorbidităţile acestuia. Astfel, elaborarea unui algoritm terapeutic ar fi de o utilitate incontestabilă, conferind posibilitatea alegerii unei tehnici fezabile leziunii însă adaptată pacientului.Cuvinte cheie: pancreas, pseudochist, tratament, drenaj AbstractFrequently appearing as a complication of pancreatitis, pancreatic pseudocysts are rare appearances in current medical practice. Multiple therapeutical options are available, from minimum invasive methods to complex open surgical techniques. The indications of drainage include symptomatic pseudocysts, large pseudocysts along with the development of complications such as hemorrhage, secondary infection, and rupture. Choosing the best drainage technique is often a challenge. Multiple factors need to be considered in managing a pseudoocyst, including its location, dimension and the patient's

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The efficacy of endoscopic treatment of pancreatic pseudocysts

Cited by 220 publications

References 30 publications

Endoscopic management of chronic pancreatitis

Endoscopic management of chronic pancreatitis

Endoscopic treatment of chronic pancreatitis

Therapeutical Aspects Regarding Pancreatic Pseudocysts

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