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 language | English |
|---|---|
| Pages (from-to) | 589-595 |
| Number of pages | 7 |
| Journal | Gastrointestinal Endoscopy |
| Volume | 78 |
| Issue number | 4 |
| DOIs | |
| State | Published - Oct 2013 |
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ASJC Scopus subject areas
- Gastroenterology
- Radiology Nuclear Medicine and imaging
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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 journal › Article
}
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 -