Investigators from the USA determined the outcome differences after endoscopic drainage of pancreatic necrosis, acute pancreatic pseudocysts, and chronic pancreatic pseudocysts.
A total of 138 consecutive patients, with symptoms caused by pancreatic fluid collections and referred for endoscopic transmural and/or transpapillary drainage, were enrolled in the study.
Outcomes were retrospectively reviewed.
Complete endoscopic resolution was achieved in 82% of the patients.
Resolution was significantly more frequent in patients with chronic pseudocysts (59/64, 92%) than acute pseudocysts (23/31, 74%) or necrosis (31/43, 72%).
|Successful endoscopic treatment:|
Chronic pseudocysts: 92%
Acute pseudocysts: 74%
| Gastrointestinal Endoscopy |
The researchers found that complications were more common in patients with necrosis (16/43, 37%) than chronic (11/64, 17%) or acute pseudocysts (6/31, 19%).
At a median follow-up of 2.1 years after successful endoscopic treatment (resolution), pancreatic fluid collections had recurred in 18 of 113 patients (16%).
Recurrences were found to develop more commonly in patients with necrosis (9/31, 29%) than acute pseudocysts (2/23, 9%) or chronic pseudocysts (7/59, 12%).
Dr Todd H. Baron, of the Mayo Medical Center, Rochester, Minnesota, said on behalf of fellow authors, "Successful resolution of pancreatic fluid collections may be achieved endoscopically by an experienced therapeutic endoscopist.
"Outcomes differ depending on the type of pancreatic fluid collection drained."
"Further studies of endoscopic drainage of pancreatic fluid collections must use defined terminology to allow meaningful comparisons," it was concluded.