Outcomes and Safety of EUS-Guided Drainage of Pancreatic Pseudocysts Using Two Double-Pigtail Plastic Stents: A Single-Center Experience

Objectives: Pancreatic pseudocysts (PPCs), persistent fluid collections resulting from pancreatic inflammation or ductal lesions, pose a clinical challenge. Endoscopic ultrasound (EUS)–guided drainage, employing various stents, has shown promise. This study aimed to assess the safety and efficacy of EUS-guided PPC drainage using double-pigtail plastic stents in a tertiary hospital.

Methods: This case series included patients referred for EUS-guided drainage of PPC between August 2022 and December 2023. The primary endpoint was the evaluation of outcomes (clinical success) and safety (adverse events and mortality) of the procedure. Secondary endpoints encompassed technical success and pseudocyst recurrence.

Results: Twenty patients (mean age: 36.8 ± 13.4 years) with PPC were enrolled, attributing to acute pancreatitis (60%) and chronic alcoholic pancreatitis (40%). The mean pseudocyst size was 12.33 ± 4.76 cm. Clinical success was achieved in 90% (18/20) of cases. The remaining two patients, with noncommunicating multiple pseudocysts, necessitated surgical intervention due to a lack of clinical success. No adverse events (false guidewire pathway, bleeding, stent occlusion) or mortality occurred. Technical success was 100%, and pseudocyst recurrence was not identified at the 12-week follow-up after successful drainage.

Conclusion: EUS-guided transmural drainage of PPC using two double-pigtail plastic stents emerges as a safe and effective procedure, exhibiting high technical and clinical success rates.

Characteristic	Value
Male/female ratio	20:0
Mean age ± SD (in years)	36.8 ± 13.43
Pseudocyst etiology, n (%)
Acute pancreatitis	12 (60%)
Chronic pancreatitis	8 (40%)
Mean size of pseudocysts, ± SD (in cm)	12.33 ± 4.78
Pseudocyst location, n (%)
Body	6 (30%)
Head	2 (10%)
Tail	3 (15%)
Body and tail	7 (35%)
Head and body	2 (10%)
Pseudocyst number, n (%)
One	14 (70%)
Two	5 (25%)
Three	1 (5%)

Characteristic	Value
Access route for EUS drainage	Transgastric (20)
Number of double-pigtail plastic stents per patient	02 (20)
Technical success, n (%)	20 (100%)
Clinical success, n (%)	18 (90%)
Adverse effects related to EUS drainage, n (%)	0
False guidewire pathway	0
Procedure-related bleeding	0
Stent occlusion	0
Persistent of pseudocyst, n (%)	2 (10%)
Pseudocyst recurrence	0
Mortality	0

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Artikel online veröffentlicht:
22. April 2024