Single Double Pigtail versus Two Double Pigtail Plastic Stent for Endoscopic Ultrasonography-Guided Drainage of Symptomatic Pancreatic Pseudocyst: A Retrospective Observational Study

Background: Endoscopic ultrasound (EUS)-guided cystogastrostomy with a single 7-French (Fr)/10 Fr double-pigtail stent (DPS) is less popular due to the concern of stent patency. We aimed to assess the effectiveness, complications, and long-term outcomes of a single 7-Fr/10Fr DPS with double 7Fr/10Fr DPS in the endoscopic drainage of symptomatic pseudocysts, containing minimal debris up to 30%.

Methods: A retrospective review of patients with symptomatic pancreatic pseudocysts, who underwent EUS-guided cystogastrostomy during March 2020 to August 2023.

Results: Of 30 patients, 14 patients underwent endoscopic ultrasound-guided drainage of uncomplicated pseudocysts using a single DPS (either 7-Fr × 7 cm or 10-Fr × 7). The mean pseudocyst size was 10.8 ± 3.9 cm. Stent placement had a 100% technical and clinical success, defined as complete resolution of symptoms and regression of the cyst size by more than 50% at 4 weeks after drainage. Whereas 16 patients underwent endoscopic ultrasound-guided drainage of uncomplicated pseudocysts using double DPS (two 10-Fr × 7 or 1 10-Fr and another 7-Fr). The mean pseudocyst size was 12 ± 4.1 cm. Stent placement had a 100% technical and clinical success in double DPS. The pseudocysts resolved without recurrence in both the groups at 6 months follow-up. Spontaneous stent migration seen in 2 in single DPS group and 1 in double DPS group. No additional interventions were required in both the groups.

Conclusion: Symptomatic pseudocysts with debris content up to 30% can be treated effectively with a single DPS (either 7-Fr or 10-Fr) as it provides comparable clinical success and long-term outcomes as using multiple stents.

Publication History

Article published online:
22 April 2024