Single-step versus two-step endo-ultrasonography-guided drainage of pancreatic pseudocyst

J Dig Dis. 2012 Jan;13(1):47-53. doi: 10.1111/j.1751-2980.2011.00547.x.

Abstract

Objective: The aim of this prospective study was to compare the feasibility, technical success rate and complication between single-step endo-ultrasonography (EUS)-guided and two-step EUS-guided drainage technique for symptomatic pancreatic pseudocyst (PP).

Methods: Twenty-one PP patients with clear intra-cystic fluid that needed to be drained were divided into two groups, depending on the availability of the therapeutic echoendoscope at the time of the procedure: Group 1 (13 patients) underwent a single-step EUS-guided endoscopic drainage and Group 2 (8 patients) underwent a two-step EUS-guided drainage technique.

Results: In Group 1 immediate technical success was achieved in 92.3% (12/13); two patients had recurrent PP and both were successfully treated by a second EUS-guided drainage. Clinical success was achieved in all cases. In Group 2 technical success was achieved in 75.0% of the patients (6/8). One patient (12.5%) bled 36 h after the procedure. Five out of 6 patients had long-term success. Clinical success was significantly greater in Group 1 (P < 0.05).

Conclusion: The technique of single-step EUS-guided drainage was superior to the technique of a two-step EUS-guided drainage technique for PP drainage.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Drainage / instrumentation
  • Drainage / methods*
  • Endosonography / instrumentation
  • Endosonography / methods*
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Gastrostomy
  • Humans
  • Male
  • Middle Aged
  • Pancreatic Pseudocyst / diagnostic imaging*
  • Pancreatic Pseudocyst / surgery
  • Pancreatic Pseudocyst / therapy*
  • Pancreatitis, Chronic / complications
  • Prospective Studies
  • Stents / standards*
  • Treatment Outcome