BACKGROUND: Endoscopic drainage of pancreatic pseudocysts and abscesses has been shown to be an effective treatment modality. A major determinant for successful cyst resolution is the insertion of multiple endoprostheses and/or placement of a nasocystic drain, which require repeated entries of a catheter into the pseudocyst to reintroduce the guidewire. OBJECTIVE: We describe a novel and easy technique to prevent the need for repeated access into the pseudocyst, thereby facilitating the placement of multiple endoprostheses by using a commercially available guiding system for stent introduction. DESIGN: Case series. SETTING: Academic Medical Center, The Netherlands. PATIENTS: Eight consecutive patients with symptomatic pancreatic pseudocysts after acute pancreatitis. INTERVENTIONS: Intracystic wire exchange for the insertion of multiple stents in endoscopic treatment of pancreatic pseudocysts by using an echoendoscope. MAIN OUTCOME MEASUREMENTS: Feasibility of intracystic wire exchange and complications. RESULTS: No guidewire access to the pseudocyst was lost. The procedure was well tolerated by the patients. Complete pseudocyst resolution was established in all patients. CONCLUSIONS: The endoscopic appliance of multiple stents becomes easier when using intracystic wire exchange for transgastric pancreatic pseudocyst drainage.
BACKGROUND: Endoscopic drainage of pancreatic pseudocysts and abscesses has been shown to be an effective treatment modality. A major determinant for successful cyst resolution is the insertion of multiple endoprostheses and/or placement of a nasocystic drain, which require repeated entries of a catheter into the pseudocyst to reintroduce the guidewire. OBJECTIVE: We describe a novel and easy technique to prevent the need for repeated access into the pseudocyst, thereby facilitating the placement of multiple endoprostheses by using a commercially available guiding system for stent introduction. DESIGN: Case series. SETTING: Academic Medical Center, The Netherlands. PATIENTS: Eight consecutive patients with symptomatic pancreatic pseudocysts after acute pancreatitis. INTERVENTIONS: Intracystic wire exchange for the insertion of multiple stents in endoscopic treatment of pancreatic pseudocysts by using an echoendoscope. MAIN OUTCOME MEASUREMENTS: Feasibility of intracystic wire exchange and complications. RESULTS: No guidewire access to the pseudocyst was lost. The procedure was well tolerated by the patients. Complete pseudocyst resolution was established in all patients. CONCLUSIONS: The endoscopic appliance of multiple stents becomes easier when using intracystic wire exchange for transgastric pancreatic pseudocyst drainage.
Authors: Mouen A Khashab; Anne Marie Lennon; Vikesh K Singh; Anthony N Kalloo; Samuel A Giday Journal: Surg Endosc Date: 2012-04-27 Impact factor: 4.584
Authors: Peter V Draganov; Lukasz Kowalczyk; Ali Fazel; Koorosh Moezardalan; Jen-Jung Pan; Chris E Forsmark Journal: Dig Dis Sci Date: 2010-02 Impact factor: 3.199