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Pancreatic pseudocyst drainage in children by image-guided cystogastrostomy and stent insertion

BACKGROUND: Endoscopic ultrasound is seldom available at paediatric centres; therefore drainage of pancreatic pseudocysts in children has traditionally been achieved by surgery. OBJECTIVE: This study assessed the feasibility and safety of performing image-guided internal drainage of pancreatic pseud...

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Autores principales: Patel, Premal A., Gibson, Craig, Minhas, Kishore S., Stuart, Sam, De Coppi, Paolo, Roebuck, Derek J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6863939/
https://www.ncbi.nlm.nih.gov/pubmed/31342130
http://dx.doi.org/10.1007/s00247-019-04471-9
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author Patel, Premal A.
Gibson, Craig
Minhas, Kishore S.
Stuart, Sam
De Coppi, Paolo
Roebuck, Derek J.
author_facet Patel, Premal A.
Gibson, Craig
Minhas, Kishore S.
Stuart, Sam
De Coppi, Paolo
Roebuck, Derek J.
author_sort Patel, Premal A.
collection PubMed
description BACKGROUND: Endoscopic ultrasound is seldom available at paediatric centres; therefore drainage of pancreatic pseudocysts in children has traditionally been achieved by surgery. OBJECTIVE: This study assessed the feasibility and safety of performing image-guided internal drainage of pancreatic pseudocysts with a flanged self-expanding covered nitinol pancreatic pseudocyst drainage stent. MATERIALS AND METHODS: We conducted a retrospective case note review of children undergoing image-guided cystogastrostomy at two paediatric hospitals. Percutaneous access to the stomach was achieved via an existing gastrostomy tract or image-guided formation of a new tract. Under combined ultrasound, fluoroscopic or cone-beam CT guidance the pancreatic pseudocysts were punctured through the posterior wall of the stomach. A self-expanding covered nitinol stent was deployed to create a cystogastrostomy opening. RESULTS: Image-guided cystogastrostomy was performed in 6 children (4 male; median age 6 years, range 46 months to 15 years; median weight 18 kg, range 13.8–47 kg). Two children had prior failed attempts at surgical or endoscopic drainage. Median maximum cyst diameter was 11.5 cm (range 4.7–15.5 cm) pre-procedure. Technical success was 100%. There were no complications. There was complete pseudocyst resolution in five children and a small (2.1-cm) residual pseudocyst in one. Pseudocyst-related symptoms resolved in all children. CONCLUSION: Pancreatic pseudocyst drainage can be successfully performed in children by image-guided placement of a cystogastrostomy stent. In this cohort of six children there were no complications.
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spelling pubmed-68639392019-12-05 Pancreatic pseudocyst drainage in children by image-guided cystogastrostomy and stent insertion Patel, Premal A. Gibson, Craig Minhas, Kishore S. Stuart, Sam De Coppi, Paolo Roebuck, Derek J. Pediatr Radiol Original Article BACKGROUND: Endoscopic ultrasound is seldom available at paediatric centres; therefore drainage of pancreatic pseudocysts in children has traditionally been achieved by surgery. OBJECTIVE: This study assessed the feasibility and safety of performing image-guided internal drainage of pancreatic pseudocysts with a flanged self-expanding covered nitinol pancreatic pseudocyst drainage stent. MATERIALS AND METHODS: We conducted a retrospective case note review of children undergoing image-guided cystogastrostomy at two paediatric hospitals. Percutaneous access to the stomach was achieved via an existing gastrostomy tract or image-guided formation of a new tract. Under combined ultrasound, fluoroscopic or cone-beam CT guidance the pancreatic pseudocysts were punctured through the posterior wall of the stomach. A self-expanding covered nitinol stent was deployed to create a cystogastrostomy opening. RESULTS: Image-guided cystogastrostomy was performed in 6 children (4 male; median age 6 years, range 46 months to 15 years; median weight 18 kg, range 13.8–47 kg). Two children had prior failed attempts at surgical or endoscopic drainage. Median maximum cyst diameter was 11.5 cm (range 4.7–15.5 cm) pre-procedure. Technical success was 100%. There were no complications. There was complete pseudocyst resolution in five children and a small (2.1-cm) residual pseudocyst in one. Pseudocyst-related symptoms resolved in all children. CONCLUSION: Pancreatic pseudocyst drainage can be successfully performed in children by image-guided placement of a cystogastrostomy stent. In this cohort of six children there were no complications. Springer Berlin Heidelberg 2019-07-24 2019 /pmc/articles/PMC6863939/ /pubmed/31342130 http://dx.doi.org/10.1007/s00247-019-04471-9 Text en © The Author(s) 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Article
Patel, Premal A.
Gibson, Craig
Minhas, Kishore S.
Stuart, Sam
De Coppi, Paolo
Roebuck, Derek J.
Pancreatic pseudocyst drainage in children by image-guided cystogastrostomy and stent insertion
title Pancreatic pseudocyst drainage in children by image-guided cystogastrostomy and stent insertion
title_full Pancreatic pseudocyst drainage in children by image-guided cystogastrostomy and stent insertion
title_fullStr Pancreatic pseudocyst drainage in children by image-guided cystogastrostomy and stent insertion
title_full_unstemmed Pancreatic pseudocyst drainage in children by image-guided cystogastrostomy and stent insertion
title_short Pancreatic pseudocyst drainage in children by image-guided cystogastrostomy and stent insertion
title_sort pancreatic pseudocyst drainage in children by image-guided cystogastrostomy and stent insertion
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6863939/
https://www.ncbi.nlm.nih.gov/pubmed/31342130
http://dx.doi.org/10.1007/s00247-019-04471-9
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