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German experience with endoscopic transmural drainage for pancreatic pseudocysts
Author(s) -
Dohmoto Matatoshi,
Rupp Dietrich K.
Publication year - 2001
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1046/j.1443-1661.2001.00127.x
Subject(s) - medicine , pancreatic pseudocyst , pancreatitis , surgery , drainage , cyst , abdominal pain , ecology , biology
Background: Endoscopic drainage provides a good alternative or supplement to a surgical approach for the therapy of pancreatic pseudocysts. Methods: Between 1987 and 2000, 47 patients had been treated for pancreatic pseudocysts by transmural or transductal drainage. In 79% the pseudocysts were due to chronic pancreatitis mainly caused by alcoholism. The main symptoms were abdominal pain in 85% of patients and loss of appetite or weight in 60% of patients. In 17% of patients, signs of septicemia were observed. Results: In 42 patients pancreatic pseudocysts disappeared completely. In the remaining five cases drainage was not successful. Six patients suffered a relapse 7–38 months after drainage. No other recurrences were followed up within 4–10 years. In another six patients the prostheses were renewed because of occlusion or dislocation. Overall six patients had to undergo surgery, three patients because of relapsing cyst, two patients because of insufficient drainage and one patient because of severe bleeding. There was no case of death related to the endoscopic treatment. Conclusions: Since the development of a modified needle type cystotom, the puncture and insertion of the prosthesis for pancreatic cyst drainage is less precarious and quicker. The endoscopic sonography is a valuable supplement to the diagnostic procedure to localize the optimal spot for puncture and to avoid hemorrhage because of damage of intramural or extramural blood vessels. Advantages of endoscopic drainage are minimal invasiveness, short period of hospitalization and low costs. These aspects make endoscopic therapy the first choice of treatment of pancreatic pseudocysts.