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Endoscopic drainage for pancreatic pseudocyst in children
I Patty1, M Kalaoui, M Al-Shamali
1Gastroenterology Center, Amiri Hospital, Kuwait.
Insights
Endoscopic cystogastrostomy offers a safe and effective treatment for nonresolving pancreatic pseudocysts (PP) in children. This minimally invasive procedure led to complete regression of PP in all cases without complications.
Area of Science:
- Pediatric Gastroenterology
- Minimally Invasive Surgery
- Endoscopic Procedures
Background:
- Pancreatic pseudocysts (PP) in children can be challenging to manage, especially when nonresolving.
- Traditional surgical interventions carry significant risks for pediatric patients.
- Endoscopic drainage presents a less invasive alternative for PP management.
Observation:
- Three pediatric patients with large, nonresolving pancreatic pseudocysts underwent endoscopic cystogastrostomy.
- The pseudocysts, resulting from trauma or idiopathic pancreatitis, were confirmed suitable for gastric drainage via imaging.
- A double pig-tail stent was placed for permanent drainage after cyst puncture.
Findings:
- Complete regression of pancreatic pseudocysts was observed in all three children within 6-8 weeks post-procedure.
- The endoscopic cystogastrostomy procedure was well-tolerated, with no procedure-related complications reported.
- Long-term follow-up of up to 2 years showed no recurrence of the pseudocysts.
Implications:
- Endoscopic cystogastrostomy is a safe and effective treatment option for pediatric patients with anatomically accessible nonresolving pancreatic pseudocysts.
- This minimally invasive approach avoids the risks associated with open surgery in children.
- Further research can explore the broader application of endoscopic drainage for pediatric pancreatic fluid collections.
Abstract:
The authors report here the results of endoscopic cystogastrostomy performed on 3 children aged 11, 3, and 2.5 years with nonresolving pancreatic pseudocyst (PP) of 12, 9.5, and 7 cm in diameter. The etiology of PP was abdominal trauma in 2 and idiopathic acute pancreatitis in 1 case. Ultrasound and computed tomography scans confirmed the diagnosis and suitability for gastric drainage. After the puncture of cyst, a double pig-tail stent was placed for the permanent drainage of cystogastrostomy. Complete regression was confirmed by follow-up ultrasonography at 8, 6, and 7 weeks, respectively. There were no procedure-related complications, nor was there a recurrence of cyst during the 2 years of follow-up. This report suggests that children with nonresolving PP, that are anatomically accessible, can be treated successfully and safely by endoscopic drainage.
