Endoscopic ultrasound guided procedures on panceatic fluid

Introduction: Pancreatic fluid often appear after acut pancreatitis, or associate with pancreatic neoplasms.

Aims: Fluid samlpe taking by endoscopic ultrasound guided FNA for diagnosis pseodocyst malignancy.

Patients and methods: In four years (2008 – 2012) period 981 patient were examined by echoendoscop, 221 of them for pancreatic laesions. In 15 cases endoscopic pseudocysts drainage (EPD) were performed Most of the cases went throught on ERCP to exclude major ductal leakage. In 14 caeses the pseuodocysts were drainaged with double pigtail endocystic plastic drain (7 and/or 10 F) throw the gastric wall, using endosonography. In one case self expanded metal stent (SEMS) was used to epmtying the pseudocyst followed acut necrotising pancreatitis.

Results: Our results revealed eligible cystemptying. Applying SEMS the EPD become „one step” procedure assured a large diameter of flow. In 30 cases the pancreatic fluid were only punctured.for diagnostic goals the cysts were not drainged, because of small diameter in 15 cases (2 – 3,5 cm) or bescause of septal structure of the pseudocyst. Mucinous cystadenoma were found in several cases mostly females (60 – 75yrs), were operated on.. In other cases pancreas neoplasm were the cytological diagnosis.

Conclusion: The echoendoscope fine needle biopsy and aspiration is a well known method to distinguish malignant formations. In caeses of EPD using doppler echo effect ideal puncture site could be localising by excluding the intra cystic mass, and cystic wall vessels. Applying SEMS assured more simple modality of pseudocyst drainage..