Endoscopic drainage of pancreatic pseudocysts

Pancreatic pseudocysts have traditionally been treated surgically or percutaneously. More recently, endotherapy has been used to decompress enlarging or symptomatic pseudocysts. This manuscript encompasses personal experience and recent literature reports to define the techniques, complications, and short‐ and long‐term results with endoscopic drainage of pancreatic pseudocysts. Three series have reported the transpapillary drainage of pseudocysts. At a mean follow‐up of 15—37 months, endotherapy was definitive in 80%, with 0% mortality, 5%—22% morbidity, and a recurrence rate of 6%—9%. Two large series have reported transgastric or transduodenal fistulization. Endoscopic treatment was definitive in 72% and 88%, respectively. Complications approximated 15%, recurrence ranged between 12% and 18%, and there was a single mortality. The majority of published series have used a combination of drainage techniques contingent upon patient anatomy delineated by endoscopic retrograde cholargio pancreatography. These series have reported long‐term drainage success in 65%—94%, complications ranging between 4% and 24%, and recurrences that have ranged from 8% to 23%. Endotherapy to drain pancreatic pseudocysts is both technically feasible and effective in a subset of patients with symptomatic pseudocysts.