EUS-guided one-step drainage of pancreatic pseudocysts: report of 3 cases / 中华消化内镜杂志

ABSTRACT

Objective To evaluate the significance of color Doppler EUS in the pancreatic pseudo-cysts drainage. Methods EUS - guided cystoenterostomy was performed in 3 patients. A needle and drainage tube was inserted in a one - step procedure into the cyst through the accessory channel of echoendoscope under EUS. The nasal plastic drainage tube was released immediately after insertion. Results When gastric ulcer and bleeding or the bulge of stomach were not found endoscopically in all patients . The needle with its stylet inserted through the gastric wall into the cyst at the site with minimal distance between them . The mean size of the pseudocysts was approximately 8 cm located at pancreatic tail ,body or the junction of them. In 3 cases but one, the blood flow signal around the cyst was not found . No significant echo of laminated structure between gastric and cyst wall was found . After aspiration or installation of naso-cystic drainage catheter, abdominal pain remitted at 2 days, 2 days and 3 days; the sonography demonstrated that cyst size decreased began from 3rd day ,and the cyst obliterated at 14 and 30 days after drainage. The only complication was found in one patient with gastric mucosal ooze, which recovered after noradrenaline spray . Infection or perforation never occurred. No recurrence of pseudocysts observed at a mean follow - up period of 3. 6 months (range 2-7 months). Conclusions The EUS-guided drainage of pancreatic pseudocysts in one-step is a rather simple and practical procedure with minimal risk of hemorrhage and infection.