EUS-guided Pancreatic Pseudocyst Drainage: an Assessment of Efficacy, Safety, Long-term Follow-up, and Technical Feasibility of Single-step Approach

Background: Pancreatic-pseudocyst is common complication of acute and chronic-pancreatitis. While surgery is associated with significant complications and mortality, percutaneous-drainage is associated with prolonged hospitalization and often times the need for other adjunctive-treatment. Aim: Assess the safety, efficacy;cacy of single-step EUS-guided pseudocyst drainage, evaluate the technical Feasibility. Methods: 69patients who had undergone Single-step EUS guided drainage of pancreatic pseudocyst were included. Controlled radial expansion wire guided balloon dilation of the puncture tract was performed followed by insertion 10Fr double pigtail stents were inserted into the pseudocyst from either the stomach or the duodenum in adults and 7Fstents in children. Results: The mean-age of 39years. Median size was 12.5cm in diameter. 56patients had infected and rest had non-infected pseudocyst. Stent placement was successful in all. The technical success rate was100%, and the treatment success rate was98.5%. 54patients had cystogastrostomy and rest had cystoduodenostomy with cyst drainage. There was one case with perforation and required surgery. 98.5%patients had complete resolution of a pseudocyst. The double pigtail stent was removed in all after median-duration of 10weeks. Regarding long-term outcomes, recurrence of a pseudocyst was not observed over a median-follow-up of 58 weeks.Conclusions: Single-step method is safe and associated with high success rate. It can be the first choice for therapy of pancreatic pseudocyst with good technical feasibility, efficacy, and safety with long-term results are acceptable