Efficacy of Endoscopic Ultrasound-Guided Drainage of Pancreatic Pseudocysts in a Pediatric Population
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Saad F. Jazrawi Bradley A. Barth Jayaprakash Sreenarasimhaiah
- چاپ و سال / کشور: 2010
Description
Background While pancreatitis is uncommon in children, pseudocyst development can be a serious complication. Endoscopic drainage of pseudocysts is well established in adults. However, there are limited data regarding this procedure in a pediatric population. The objective of this study is to determine the safety and efficacy of endoscopic ultrasound-guided pseudocyst drainage in children. Methods The study group included children (age \18 years) who presented for endoscopic drainage of symptomatic pancreatic pseudocysts in whom endoscopic ultrasound (EUS) was performed. In those cases with EUS guidance, a 19-gauge needle was used to access the pseudocyst and place a guidewire under fluoroscopic visualization. Needle-knife diathermy and balloon dilation of the tract were performed with subsequent placement of double pig-tailed stents for drainage. Results Ten children with mean age of 11.8 years (range 4–17 years) were analyzed for pancreatic pseudocysts due to biliary pancreatitis (n = 4), trauma (n = 2), familial pancreatitis (n = 1), idiopathic pancreatitis (n = 2), and pancreas divisum (n = 1). In eight cases, EUS-guided puncture and stent placement was successful. In the remaining two cases, aspiration of cyst fluid until complete collapse was adequate. As experience increased with EUS examination in children, the therapeutic EUS scope alone was used in 50% of cases for the entire procedure. In all ten cases, successful transgastric endoscopic drainage of pseudocysts was achieved. Conclusions Endoscopic drainage of symptomatic pancreatic pseudocysts can be achieved safely in children. EUS guidance facilitates optimal site of puncture as well as placement of transmural stents.
Dig Dis Sci (2011) 56:902–908 DOI 10.1007/s10620-010-1350-y Received: 23 April 2010 / Accepted: 12 July 2010 / Published online: 30 July 2010
