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Endoscopic ultrasound-guided drainage of pancreatic fluid collections in children
Jayapal Ramesh1, Ji Y Bang, Jessica Trevino
1Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, Alabama 35294, USA. j1ramesh@gmail.com
Insights
Single-step endoscopic ultrasound (EUS)-guided drainage of pancreatic fluid collections (PFCs) is a safe and effective treatment for children. This minimally invasive approach offers a 100% success rate and should be considered a first-line option.
Area of Science:
- Pediatric Gastroenterology
- Minimally Invasive Procedures
- Pancreatic Diseases
Background:
- Endoscopic ultrasound (EUS)-guided drainage is standard for adult pancreatic fluid collections (PFCs).
- The efficacy of single-step EUS-guided drainage in pediatric PFCs remains unclear.
Purpose of the Study:
- To evaluate the safety and efficacy of single-step EUS-guided drainage for PFCs in children.
Main Methods:
- Retrospective analysis of pediatric patients undergoing single-step EUS-guided PFC drainage.
- Pre-procedure endoscopic retrograde cholangiopancreatography was used to assess the pancreatic duct.
Main Results:
- Seven children (mean age 8.4 years) underwent the procedure.
- 100% technical and treatment success rates were achieved.
- No immediate or delayed complications were reported, with no recurrence at median follow-up of 1033 days.
Conclusions:
- Single-step EUS-guided drainage is a safe, feasible, and effective first-line treatment for pediatric PFCs.
- This minimally invasive technique demonstrates excellent outcomes in children.
Background And Objective:
Although endoscopic ultrasound (EUS)-guided drainage of pancreatic fluid collections (PFCs) has evolved as the standard of care in adults, its role as a single-step drainage modality in children is unclear. The aim of the present study was to evaluate the efficacy and safety of single-step EUS-guided drainage of PFCs in children.
Methods:
This is a retrospective study of all of the children who underwent single-step EUS-guided drainage of PFCs during a 4-year period at 1 institution. An endoscopic retrograde cholangiopancreatography was attempted before EUS-guided drainage to evaluate the pancreatic duct and bridge any ductal disruption.
Results:
A total of 7 children (4 boys; mean age 8.4 years [standard deviation 2.1]) underwent EUS-guided drainage of PFCs. The etiology was blunt abdominal trauma in 5, hereditary pancreatitis in 1, and idiopathic pancreatitis in 1. Both technical and treatment success rates were 100% with median procedural duration of 12 minutes (interquartile range 12-20 minutes). Two patients underwent repeat EUS-guided drainage due to lack of adequate resolution of PFC on follow-up computed tomography. There were no immediate or delayed complications. At a median follow-up of 1033 days (interquartile range 193-1167 days), all of the children were doing well with no PFC recurrence.
Conclusions:
Single-step EUS-guided drainage of PFC in children is technically feasible, safe, clinically effective, and when available, should be the first-line treatment modality.
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