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Endoscopic drainage of pancreatic pseudocysts in children
Saud Al-Shanafey1, Albert Shun, Steven Williams
1Department of Paediatric Surgery, The Children's Hospital at Westmead, NSW, Sydney, Australia.
Insights
Endoscopic drainage of pancreatic pseudocysts (EDPP) is a safe and effective treatment option for children. This study shows successful outcomes in three pediatric patients, highlighting its utility in pediatric care.
Area of Science:
- Pediatric Gastroenterology
- Minimally Invasive Procedures
- Gastrointestinal Endoscopy
Background:
- Pancreatic pseudocysts in children are challenging to manage.
- Established adult protocols for endoscopic drainage of pancreatic pseudocyst (EDPP) require pediatric validation.
- Traditional treatments include surgery and percutaneous methods.
Observation:
- A retrospective review of three pediatric patients (ages 9, 13, 14) treated with EDPP between 1997-2001.
- Etiologies included anomalous pancreatic divisum ducts and azathioprine-induced pancreatitis.
- Procedures involved endoscopic transpapillary drainage and endoscopic cystduodenostomy.
Findings:
- All three patients achieved complete clinical and radiological resolution of pseudocysts.
- Follow-up periods ranged from 3 to 31 months.
- One patient required a subsequent pancreaticojejunostomy for chronic pancreatitis symptoms.
Implications:
- Endoscopic drainage of pancreatic pseudocysts is a viable and safe option for pediatric patients.
- EDPP offers a less invasive alternative to surgery for pediatric pancreatic pseudocysts.
- Further research should explore long-term outcomes and broader applications in children.
Background/Purpose:
Symptomatic pancreatic pseudocysts have traditionally been managed with surgical, percutaneous, and, more recently, endoscopic drainage. Although the role of the latter is well defined in the adult population, its utility in children needs to be clarified. The authors reviewed their experience with endoscopic drainage of pancreatic pseudocyst (EDPP).
Methods:
A retrospective chart review was conducted, and relevant demographic and clinical data were obtained for all patients with pancreatic pseudocysts managed with endoscopic drainage in the period from 1997 through 2001, inclusive.
Results:
Three children had successful endoscopic drainage of pancreatic pseudocysts. They were 9, 13, and 14 years old, and were all boys. The etiology of the pancreatitis was idiopathic related to anomalous pancreatic divisum ducts in the first 2 and azathioprine induced in the latter. The first 2 patients had endoscopic transpapillary drainage, whereas the third had an endoscopic cystduodenostomy. All patients had complete resolution of the pseudocyst clinically and radiologically after follow-up periods of 3, 31, and 21 months, respectively. The first needed a subsequent pancreaticojejunostomy for persistent symptoms related to chronic pancreatitis. A successful endoscopic drainage of a posttraumatic pancreatic pseudocyst has previously been reported from our institution.
Conclusions:
This experience would indicate that endoscopic drainage of pancreatic pseudocyst is an effective and relatively safe option of managing this problem in children.
