[Endoscopic therapy of pancreatic pseudocysts]

Pancreatic pseudocysts are a complication of both acute and chronic pancreatitis. Incidence in patients with acute pancreatitis is 2-50%, in patients with chronic pancreatitis 20-40%. Pseudocysts are a cause of many symptoms, e.g. nausea, vomitus, pain, biliary obstruction, bleeding and perforation. Successful treatment of pseudocysts is not only surgical and percutaneous, but also endoscopic.

The aim of this study was to answer the following questions. First, what is the clinical success rate of endoscopic drainage of pancreatic pseudocysts? Second, what are the complications? Finally, how often is endoscopic drainage a definite treatment?

The records of all patients (11) with chronic pancreatitis and endoscopic drainage of symptomatic pseudocysts hospitalized between December 1993 and April 1999 at our clinic were retrospectively studied.

Patients (5) were followed for a mean duration of 30 months. Endoscopic drainage was definitive treatment in 80%, after transgastric drainage in 50%, after transpapillary drainage in 100% and after the use of more than one drainage procedure in 0%. The prognostic factors for longterm success of endoscopic drainage could not be evaluated, because of the small number of treated patients.

Endoscopic treatment of pancreatic pseudocysts (endoscopic cystogastrostomy, cystoduodenostomy and transpapillary drainage) is nowadays highly effective method, technically feasible in most patients, with a relative degree of safety when performed by experienced endoscopist. (Tab. 2, Ref. 16.)