Endoscopic Drainage of Pancreatic Pseudocysts: An Experience with 77 Patients
Background: We evaluated short‑ and long‑term results of endoscopic drainage (a minimally invasive nonsurgical treatment) of pancreatic pseudocysts (PPCs) and factors associated with its success at a multilevel teaching hospital in Northern India, as such data are scanty from India. Patients and Met...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2017-04-01
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| Series: | Journal of Digestive Endoscopy |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.4103/jde.JDE_79_16 |
| _version_ | 1818306159751200768 |
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| author | Hemanta K. Nayak Sandeep Kumar Uday C. Ghoshal Samir Mohindra Namita Mohindra Gaurav Pande Vivek Anand Saraswat |
| author_facet | Hemanta K. Nayak Sandeep Kumar Uday C. Ghoshal Samir Mohindra Namita Mohindra Gaurav Pande Vivek Anand Saraswat |
| author_sort | Hemanta K. Nayak |
| collection | DOAJ |
| description | Background: We evaluated short‑ and long‑term results of endoscopic drainage (a minimally invasive nonsurgical treatment) of pancreatic pseudocysts (PPCs) and factors associated with its success at a multilevel teaching hospital in Northern India, as such data are scanty from India. Patients and Methods: Retrospective review of records of consecutive patients undergoing endoscopic drainage of PPC from January 2002 to June 2013 was undertaken. Results: Seventy‑seven patients (56 males), median age 36 years (range, 15–73), underwent endoscopic drainage of PPC with 98% technical success. Pseudocysts drained were symptomatic (duration 11 weeks, range, 8–68), large (volume 582 mL [range, 80–2706]), located in head (n = 32, 46%), body and tail (n = 37, 54%), and infected (n = 39, 49%). Drainage procedures included cystogastrostomy (n = 54, 78%), cystoduodenostomy (n = 9, 13%), transpapillary drainage (n = 2, 3%), and multiple route (n = 4, 6%), with additional endoscopic nasocystic drainage (ENCD) in 41 (59%). Sixty‑nine patients were followed up (median 28 months, range 2–156; other eight lost to follow‑up). Complications (n = 21, 30%) included stent occlusion and migration (13), bleeding (5), perforation (2), and death (1). Endoscopic procedure had to be repeated in 19 patients (28%; 16 for sepsis, 3 for recurrence). The reasons for additional nonendoscopic treatment (n = 8, 12%) included incomplete cyst resolution (3), recurrence (2), bleeding (1), and perforation (2). Overall success rate of endoscopic drainage was 88%. Whereas infected pseudocysts were associated with poorer outcome (odds ratio [OR] 0.016; 95% confidence interval [CI] 0.001–0.037), placement of ENCD led to better results (OR 11.85; 95% CI 1.03–135.95). Conclusion: Endoscopic drainage is safe and effective for PPC. |
| first_indexed | 2024-12-13T06:38:03Z |
| format | Article |
| id | doaj.art-242a1375585543f1a098ab99f5f41a97 |
| institution | Directory Open Access Journal |
| issn | 0976-5042 0976-5050 |
| language | English |
| last_indexed | 2024-12-13T06:38:03Z |
| publishDate | 2017-04-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | Journal of Digestive Endoscopy |
| spelling | doaj.art-242a1375585543f1a098ab99f5f41a972022-12-21T23:56:28ZengThieme Medical and Scientific Publishers Pvt. Ltd.Journal of Digestive Endoscopy0976-50420976-50502017-04-01080206106710.4103/jde.JDE_79_16Endoscopic Drainage of Pancreatic Pseudocysts: An Experience with 77 PatientsHemanta K. Nayak0Sandeep Kumar1Uday C. Ghoshal2Samir Mohindra3Namita Mohindra4Gaurav Pande5Vivek Anand Saraswat6Departments of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India Departments of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India Departments of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India Departments of Radiodiagnosis, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India Departments of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India Departments of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India Departments of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India Background: We evaluated short‑ and long‑term results of endoscopic drainage (a minimally invasive nonsurgical treatment) of pancreatic pseudocysts (PPCs) and factors associated with its success at a multilevel teaching hospital in Northern India, as such data are scanty from India. Patients and Methods: Retrospective review of records of consecutive patients undergoing endoscopic drainage of PPC from January 2002 to June 2013 was undertaken. Results: Seventy‑seven patients (56 males), median age 36 years (range, 15–73), underwent endoscopic drainage of PPC with 98% technical success. Pseudocysts drained were symptomatic (duration 11 weeks, range, 8–68), large (volume 582 mL [range, 80–2706]), located in head (n = 32, 46%), body and tail (n = 37, 54%), and infected (n = 39, 49%). Drainage procedures included cystogastrostomy (n = 54, 78%), cystoduodenostomy (n = 9, 13%), transpapillary drainage (n = 2, 3%), and multiple route (n = 4, 6%), with additional endoscopic nasocystic drainage (ENCD) in 41 (59%). Sixty‑nine patients were followed up (median 28 months, range 2–156; other eight lost to follow‑up). Complications (n = 21, 30%) included stent occlusion and migration (13), bleeding (5), perforation (2), and death (1). Endoscopic procedure had to be repeated in 19 patients (28%; 16 for sepsis, 3 for recurrence). The reasons for additional nonendoscopic treatment (n = 8, 12%) included incomplete cyst resolution (3), recurrence (2), bleeding (1), and perforation (2). Overall success rate of endoscopic drainage was 88%. Whereas infected pseudocysts were associated with poorer outcome (odds ratio [OR] 0.016; 95% confidence interval [CI] 0.001–0.037), placement of ENCD led to better results (OR 11.85; 95% CI 1.03–135.95). Conclusion: Endoscopic drainage is safe and effective for PPC.http://www.thieme-connect.de/DOI/DOI?10.4103/jde.JDE_79_16 cystoduodenostomy cystogastrostomy endoscopic nasocystic drain pancreatic pseudocyst trans‑papillary drainage |
| spellingShingle | Hemanta K. Nayak Sandeep Kumar Uday C. Ghoshal Samir Mohindra Namita Mohindra Gaurav Pande Vivek Anand Saraswat Endoscopic Drainage of Pancreatic Pseudocysts: An Experience with 77 Patients Journal of Digestive Endoscopy cystoduodenostomy cystogastrostomy endoscopic nasocystic drain pancreatic pseudocyst trans‑papillary drainage |
| title | Endoscopic Drainage of Pancreatic Pseudocysts: An Experience with 77 Patients |
| title_full | Endoscopic Drainage of Pancreatic Pseudocysts: An Experience with 77 Patients |
| title_fullStr | Endoscopic Drainage of Pancreatic Pseudocysts: An Experience with 77 Patients |
| title_full_unstemmed | Endoscopic Drainage of Pancreatic Pseudocysts: An Experience with 77 Patients |
| title_short | Endoscopic Drainage of Pancreatic Pseudocysts: An Experience with 77 Patients |
| title_sort | endoscopic drainage of pancreatic pseudocysts an experience with 77 patients |
| topic | cystoduodenostomy cystogastrostomy endoscopic nasocystic drain pancreatic pseudocyst trans‑papillary drainage |
| url | http://www.thieme-connect.de/DOI/DOI?10.4103/jde.JDE_79_16 |
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