Endoscopic drainage of pancreatic pseudocysts: a long-term follow-up study of 49 patients.

Background/aims: Endoscopic drainage is one of the non-surgical treatment modalities for pancreatic pseudocysts. The aim of the current study was to assess the safety and the utility of endoscopic treatment of pancreatic pseudocysts. Prognostic factors for the outcome were evaluated in a prospective analysis.

Methodology: Forty-nine consecutive symptomatic patients were included in the study. Transmural drainage was used in 30 patients and transpapillary drainage in 19 patients.

Results: Successful drainage was achieved in 27/30 (90%) patients after transmural drainage and in 16/19 (84.2%) patients after transpapillary drainage. Twelve (24.5%) patients had complications: 2 patients had bleeding, 2 patients had mild pancreatitis, 8 patients had cyst infection, in relation to the presence of necrosis (5 patients) or clogging of the stent (3 patients). Nine patients (20.9%) had recurrence of pseudocysts. Endoscopic drainage was a definitive treatment in 37/49 (75.5%) patients (median follow up: 25.9 months).

Conclusions: Endoscopic drainage provides a successful and safe minimally invasive approach to pancreatic pseudocyst management.