Outcomes of EUS-guided drainage of debris-containing pancreatic pseudocysts by using combined endoprosthesis and a nasocystic drain

Ali A. Siddiqui, John DeWitt, Anna Strongin, Harkirat Singh, Smoker Jordan, David E. Loren, Thomas Kowalski, Mohamad A. Eloubeidi

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Background: The presence of debris within a pseudocyst may impair success of endoscopic drainage. Objective: To compare the clinical outcomes and adverse-event rates of EUS-guided pseudocyst drainage with and without a nasocystic drain for the management of pancreatic pseudocysts with viscous solid debris-laden fluid. Design: Retrospective study. Setting: Single, tertiary-care referral center. Patients: Consecutive patients with pancreatic pseudocysts managed by EUS-guided drainage: those with solid debris who underwent drainage via nasocystic drains alongside stents (n = 63) and those with solid debris who underwent drainage via transmural stents only (n = 24). Intervention: Drainage via nasocystic drains alongside stents or drainage via transmural stents only. Main Outcome Measurements: The primary outcomes were short-term success and long-term success of the procedures. The secondary outcomes were procedure-related adverse events and reintervention. Results: The patients with viscous solid debris-laden fluid whose pseudocysts were drained by both stents and nasocystic tubes had a 3 times greater short-term success rate compared with those who had drainage by stents alone (P =.03). On 12-month follow-up, complete resolution of pseudocysts with debris drained via stents alone was less (58%) compared with those with debris who underwent drainage via nasocystic drains alongside stents (79%; P =.059). The rate of stent occlusion was higher in cysts with debris drained by stents alone (33%) compared with those drained via nasocystic drains alongside stents (13%; P =.03). Limitations: Retrospective design; limited sample size. Conclusion: In patients with pseudocysts with viscous debris-laden fluid, EUS-guided drainage by using a combination of a nasocystic drain and transmural stents improves clinical outcomes and lowers the stent occlusion rate compared with those who underwent drainage via stents alone.

Original languageEnglish
Pages (from-to)589-595
Number of pages7
JournalGastrointestinal Endoscopy
Volume78
Issue number4
DOIs
StatePublished - Oct 2013

Fingerprint

Pancreatic Pseudocyst
Stents
Drainage
Tertiary Care Centers
Sample Size

ASJC Scopus subject areas

  • Gastroenterology
  • Radiology Nuclear Medicine and imaging

Cite this

Outcomes of EUS-guided drainage of debris-containing pancreatic pseudocysts by using combined endoprosthesis and a nasocystic drain. / Siddiqui, Ali A.; DeWitt, John; Strongin, Anna; Singh, Harkirat; Jordan, Smoker; Loren, David E.; Kowalski, Thomas; Eloubeidi, Mohamad A.

In: Gastrointestinal Endoscopy, Vol. 78, No. 4, 10.2013, p. 589-595.

Research output: Contribution to journalArticle

Siddiqui, Ali A. ; DeWitt, John ; Strongin, Anna ; Singh, Harkirat ; Jordan, Smoker ; Loren, David E. ; Kowalski, Thomas ; Eloubeidi, Mohamad A. / Outcomes of EUS-guided drainage of debris-containing pancreatic pseudocysts by using combined endoprosthesis and a nasocystic drain. In: Gastrointestinal Endoscopy. 2013 ; Vol. 78, No. 4. pp. 589-595.
@article{6d5062ed3ec141fa966f45045dff8cf0,
title = "Outcomes of EUS-guided drainage of debris-containing pancreatic pseudocysts by using combined endoprosthesis and a nasocystic drain",
abstract = "Background: The presence of debris within a pseudocyst may impair success of endoscopic drainage. Objective: To compare the clinical outcomes and adverse-event rates of EUS-guided pseudocyst drainage with and without a nasocystic drain for the management of pancreatic pseudocysts with viscous solid debris-laden fluid. Design: Retrospective study. Setting: Single, tertiary-care referral center. Patients: Consecutive patients with pancreatic pseudocysts managed by EUS-guided drainage: those with solid debris who underwent drainage via nasocystic drains alongside stents (n = 63) and those with solid debris who underwent drainage via transmural stents only (n = 24). Intervention: Drainage via nasocystic drains alongside stents or drainage via transmural stents only. Main Outcome Measurements: The primary outcomes were short-term success and long-term success of the procedures. The secondary outcomes were procedure-related adverse events and reintervention. Results: The patients with viscous solid debris-laden fluid whose pseudocysts were drained by both stents and nasocystic tubes had a 3 times greater short-term success rate compared with those who had drainage by stents alone (P =.03). On 12-month follow-up, complete resolution of pseudocysts with debris drained via stents alone was less (58{\%}) compared with those with debris who underwent drainage via nasocystic drains alongside stents (79{\%}; P =.059). The rate of stent occlusion was higher in cysts with debris drained by stents alone (33{\%}) compared with those drained via nasocystic drains alongside stents (13{\%}; P =.03). Limitations: Retrospective design; limited sample size. Conclusion: In patients with pseudocysts with viscous debris-laden fluid, EUS-guided drainage by using a combination of a nasocystic drain and transmural stents improves clinical outcomes and lowers the stent occlusion rate compared with those who underwent drainage via stents alone.",
author = "Siddiqui, {Ali A.} and John DeWitt and Anna Strongin and Harkirat Singh and Smoker Jordan and Loren, {David E.} and Thomas Kowalski and Eloubeidi, {Mohamad A.}",
year = "2013",
month = "10",
doi = "10.1016/j.gie.2013.03.1337",
language = "English",
volume = "78",
pages = "589--595",
journal = "Gastrointestinal Endoscopy",
issn = "0016-5107",
publisher = "Mosby Inc.",
number = "4",

}

TY - JOUR

T1 - Outcomes of EUS-guided drainage of debris-containing pancreatic pseudocysts by using combined endoprosthesis and a nasocystic drain

AU - Siddiqui, Ali A.

AU - DeWitt, John

AU - Strongin, Anna

AU - Singh, Harkirat

AU - Jordan, Smoker

AU - Loren, David E.

AU - Kowalski, Thomas

AU - Eloubeidi, Mohamad A.

PY - 2013/10

Y1 - 2013/10

N2 - Background: The presence of debris within a pseudocyst may impair success of endoscopic drainage. Objective: To compare the clinical outcomes and adverse-event rates of EUS-guided pseudocyst drainage with and without a nasocystic drain for the management of pancreatic pseudocysts with viscous solid debris-laden fluid. Design: Retrospective study. Setting: Single, tertiary-care referral center. Patients: Consecutive patients with pancreatic pseudocysts managed by EUS-guided drainage: those with solid debris who underwent drainage via nasocystic drains alongside stents (n = 63) and those with solid debris who underwent drainage via transmural stents only (n = 24). Intervention: Drainage via nasocystic drains alongside stents or drainage via transmural stents only. Main Outcome Measurements: The primary outcomes were short-term success and long-term success of the procedures. The secondary outcomes were procedure-related adverse events and reintervention. Results: The patients with viscous solid debris-laden fluid whose pseudocysts were drained by both stents and nasocystic tubes had a 3 times greater short-term success rate compared with those who had drainage by stents alone (P =.03). On 12-month follow-up, complete resolution of pseudocysts with debris drained via stents alone was less (58%) compared with those with debris who underwent drainage via nasocystic drains alongside stents (79%; P =.059). The rate of stent occlusion was higher in cysts with debris drained by stents alone (33%) compared with those drained via nasocystic drains alongside stents (13%; P =.03). Limitations: Retrospective design; limited sample size. Conclusion: In patients with pseudocysts with viscous debris-laden fluid, EUS-guided drainage by using a combination of a nasocystic drain and transmural stents improves clinical outcomes and lowers the stent occlusion rate compared with those who underwent drainage via stents alone.

AB - Background: The presence of debris within a pseudocyst may impair success of endoscopic drainage. Objective: To compare the clinical outcomes and adverse-event rates of EUS-guided pseudocyst drainage with and without a nasocystic drain for the management of pancreatic pseudocysts with viscous solid debris-laden fluid. Design: Retrospective study. Setting: Single, tertiary-care referral center. Patients: Consecutive patients with pancreatic pseudocysts managed by EUS-guided drainage: those with solid debris who underwent drainage via nasocystic drains alongside stents (n = 63) and those with solid debris who underwent drainage via transmural stents only (n = 24). Intervention: Drainage via nasocystic drains alongside stents or drainage via transmural stents only. Main Outcome Measurements: The primary outcomes were short-term success and long-term success of the procedures. The secondary outcomes were procedure-related adverse events and reintervention. Results: The patients with viscous solid debris-laden fluid whose pseudocysts were drained by both stents and nasocystic tubes had a 3 times greater short-term success rate compared with those who had drainage by stents alone (P =.03). On 12-month follow-up, complete resolution of pseudocysts with debris drained via stents alone was less (58%) compared with those with debris who underwent drainage via nasocystic drains alongside stents (79%; P =.059). The rate of stent occlusion was higher in cysts with debris drained by stents alone (33%) compared with those drained via nasocystic drains alongside stents (13%; P =.03). Limitations: Retrospective design; limited sample size. Conclusion: In patients with pseudocysts with viscous debris-laden fluid, EUS-guided drainage by using a combination of a nasocystic drain and transmural stents improves clinical outcomes and lowers the stent occlusion rate compared with those who underwent drainage via stents alone.

UR - http://www.scopus.com/inward/record.url?scp=84884419225&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84884419225&partnerID=8YFLogxK

U2 - 10.1016/j.gie.2013.03.1337

DO - 10.1016/j.gie.2013.03.1337

M3 - Article

C2 - 23660566

AN - SCOPUS:84884419225

VL - 78

SP - 589

EP - 595

JO - Gastrointestinal Endoscopy

JF - Gastrointestinal Endoscopy

SN - 0016-5107

IS - 4

ER -