Boyanov Nikola, Milinich Nikol, Shtereva Katina, Madzharova Katerina, Tufkova Stoilka, Penkova-Radicheva Mariana, Radicheva Daniela, Shopov Neno
Medical Simulation Training Center, Research Institute, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria.
Department of Gastroenterology, Pulmed University Hospital, 4000 Plovdiv, Bulgaria.
Reports (MDPI). 2024 May 17;7(2):38. doi: 10.3390/reports7020038.
: Pancreatic pseudocysts often arise as complications of pancreatitis and present unique challenges in clinical management, encompassing considerations for both technical aspects and financial implications. Before the advancements of invasive gastroenterology, pancreatic pseudocysts have been drained surgically for many years. Nowadays, we have less invasive techniques with higher efficiency and lower mortality rates, however, they remain cost-challenging for most countries. : We present four patients (two males and two females) with pancreatic pseudocysts who underwent endoscopic ultrasound-guided transgastric drainage using plastic stents accompanied by a standard lavage protocol using a nasocystic catheter. : All four patients had successful outcomes, and a follow-up at 6 months revealed no traces of the pseudocysts or any significant long-term complications. One acute complication (arterial bleeding) and one late complication (stent migration) were observed. As the study aimed to present a cheaper option for draining pancreatic pseudocysts, we investigated and compared costs for the materials we utilized and those associated with lumen-apposing metal stents. Upon compiling the data, a notable advantage was evident in favour of our method. : While EUS-guided drainage of pancreatic pseudocysts using lumen-apposing metal stents (LAMSs) represents a high-end strategy for treating pancreatic pseudocysts, our method demonstrates better cost-effectiveness without compromising efficacy.
胰腺假性囊肿常作为胰腺炎的并发症出现,在临床管理中带来独特挑战,涉及技术层面和经济影响等多方面考量。在侵入性胃肠病学发展之前,胰腺假性囊肿多年来一直通过手术引流。如今,我们有了侵入性较小、效率更高且死亡率更低的技术,然而,对大多数国家来说,这些技术在成本方面仍具有挑战性。我们介绍了4例胰腺假性囊肿患者(2例男性和2例女性),他们接受了内镜超声引导下经胃引流术,使用塑料支架,并采用鼻囊肿导管进行标准灌洗方案。所有4例患者均取得成功,6个月的随访显示假性囊肿无残留痕迹,也无任何严重的长期并发症。观察到1例急性并发症(动脉出血)和1例晚期并发症(支架移位)。由于该研究旨在提出一种更便宜的胰腺假性囊肿引流方案,我们对所使用材料的成本以及与管腔贴附金属支架相关的成本进行了调查和比较。整理数据后,明显有利于我们方法的显著优势显现出来。虽然使用管腔贴附金属支架(LAMSs)进行内镜超声引导下胰腺假性囊肿引流是治疗胰腺假性囊肿的高端策略,但我们的方法在不影响疗效的情况下显示出更好的成本效益。