Ahlawat Sushil K, Charabaty-Pishvaian Aline, Jackson Patrick G, Haddad Nadim G
Division of Gastroenterology, Department of Surgery, Georgetown University Hospital, Washington, DC 20007, USA.
JOP. 2006 Nov 10;7(6):616-24.
EUS-guided transmural drainage of pancreatic pseudocyst has been reported using a linear array echoendoscope; however, placement of large 10 French stent was not feasible because of the limited diameter of the working channel. Recently linear array echoendoscopes with large working channel (3.7 to 3.8 mm) and newer accessories for pancreatic cyst puncture have become available; however, clinical data on their efficacy and safety in pancreatic pseudocyst drainage is not available.
To evaluate efficacy and safety of a one-step real time EUS-guided pancreatic pseudocyst drainage approach using a 3.8 mm channel linear array echoendoscope and cystotome.
Prospective case series.
Tertiary care hospital endoscopy unit.
A total of 12 EUS-guided pancreatic pseudocyst drainage procedures were performed in 11 patients with symptomatic pancreatic pseudocyst using a 3.8 mm channel linear array echoendoscope and cystotome.
Complete resolution of pancreatic pseudocyst on imaging.
Successful puncture of pancreatic pseudocyst and placement of 1 or 2 stents (10 Fr) was successful in all patients who were considered eligible for EUS-guided pancreatic pseudocyst drainage. Overall 9 patients out of a total of 11 (82%) were managed successfully with EUS-guided pseudocyst drainage. Two recurrences were noted over a mean follow-up period of 4 months (range 3-6 months). One patient underwent successful repeat drainage and the other patient was managed with surgical cystogastrostomy because of infected cyst contents. No major complication occurred.
Uncontrolled, small sample size.
A single-step approach using a large channel (3.8 mm) linear array echoendoscope and cystotome appears feasible. This approach appears safe and effective in managing selected patients with symptomatic pancreatic pseudocysts.
已有报道使用线性阵列超声内镜进行超声内镜引导下胰腺假性囊肿的经壁引流；然而，由于工作通道直径有限，放置大型10法式支架不可行。近来，具有大工作通道（3.7至3.8毫米）的线性阵列超声内镜以及用于胰腺囊肿穿刺的新型附件已可获得；然而，关于它们在胰腺假性囊肿引流中的疗效和安全性的临床数据尚无可用。
评估使用3.8毫米通道线性阵列超声内镜和囊肿切开刀的一步实时超声内镜引导下胰腺假性囊肿引流方法的疗效和安全性。
前瞻性病例系列。
三级医疗医院内镜科。
使用3.8毫米通道线性阵列超声内镜和囊肿切开刀，对11例有症状的胰腺假性囊肿患者共进行了12次超声内镜引导下胰腺假性囊肿引流手术。
影像学上胰腺假性囊肿完全消退。
所有被认为适合超声内镜引导下胰腺假性囊肿引流的患者均成功穿刺胰腺假性囊肿并放置1或2个（10法式）支架。总共11例患者中，总体有9例（82%）通过超声内镜引导下假性囊肿引流成功治疗。在平均4个月（范围3 - 6个月）的随访期内观察到2例复发。1例患者成功接受重复引流，另1例患者因囊肿内容物感染接受了手术性囊肿胃吻合术。未发生重大并发症。
未设对照，样本量小。
使用大通道（3.8毫米）线性阵列超声内镜和囊肿切开刀的单步方法似乎可行。这种方法在治疗部分有症状的胰腺假性囊肿患者中似乎安全有效。
