Endoscopy 2005; 37(10): 977-983
DOI: 10.1055/s-2005-870336
Original Article
© Georg Thieme Verlag KG Stuttgart · New York

Endoscopic Drainage of Pancreatic Pseudocysts: Long-Term Outcome and Procedural Factors Associated with Safe and Successful Treatment

D.  Cahen1 , E.  Rauws1 , P.  Fockens1 , G.  Weverling2 , K.  Huibregtse1 , M.  Bruno1
  • 1Dept. of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, the Netherlands
  • 2Dept. of Clinical Epidemiology and Biostatistics, Academic Medical Center, Amsterdam, the Netherlands
Further Information

Publication History

Submitted 4 April 2004

Accepted after Revision 15 April 2005

Publication Date:
27 September 2005 (online)

Background and Study Aims: Endoscopic drainage is a widely used treatment modality for pancreatic pseudocysts and has challenged more traditional drainage techniques. This retrospective study evaluates the short-term and long-term results with this technique and aims to identify procedural modifications that may improve its safety and efficacy.
Patients and Methods: All consecutive patients who underwent endoscopic drainage of pancreatic pseudocysts in our hospital between 1983 and 2000 were included in the study. The patients’ charts were reviewed, and long-term follow-up data were obtained by written questionnaires sent to the patients at the end of the follow-up period in November 2002.
Results: A total of 92 patients were included (66 men, 26 women; median age 49 years). The technical success rate of the drainage procedure was 97 % and the mortality rate was 1 %. Complications occurred in 31 patients (34 %), eight of which (9 %) were major and required surgery: hemorrhage in four cases (three of which were caused by erosion of a straight endoprosthesis through the cyst wall), secondary infection in three, and perforation in one. During a median follow-up period of 43 months, 10 patients (11 %) underwent additional (nonendoscopic) treatment for a persistent cyst and five (5 %) for a recurrent cyst. Overall, endoscopic drainage was successful in 65 patients (71 %).
Conclusions: Endoscopic drainage is an effective treatment for pancreatic pseudocysts and offers a definitive solution in almost three-quarters of the cases. The majority of major complications might have been prevented by using pigtail stents instead of straight stents and by taking a more aggressive approach to the prevention and treatment of secondary cyst infection.

References

D. L. Cahen , M. D.

Dept. of Gastroenterology and Hepatology

Academic Medical Center · Meibergdreef 9 · 1105 AZ Amsterdam · The Netherlands

Fax: +31-20-6917033

Email: d.l.cahen@amc.uva.nl