Eficácia e complicações da drenagem de pseudocistos de pâncreas guiada por ecoendoscopia

• Autor(a) principal: Sousa, Giovana Biasia De [UNIFESP]
• Data de Publicação: 2019
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=7748490; https://repositorio.unifesp.br/handle/11600/59114
• topic: Pancreatic Pseudocyst; Drainage; Endoscopy; Endosonography; Pseudocisto Pancreático; Drenagem; Endoscopia; Endossonografia

Introduction: Pancreatic pseudocyst refers specifically to a fluid collection in the peripancreatic tissues that it surrounded by a well defined wall and contains essentially no solid material. It has been successfully treated by EUS-guided drainage using different stents. Aims: to evaluate the safety and efficacy of EUS-guided pancreatic pseudocyst drainage using plastic double-pigtail stents in a tertiary hospital. Patients and Methods: we reviewed the results of 9 patients (median age 42 years [range: 14 – 79]; 67% male) with symptomatic pancreatic pseudocyst. Indication EUS-guided drainage was abdominal pain (8), gastric outlet obstruction (4) and biliary obstruction (1). The etiology was acute pancreatitis (4), chronic pancreatitis (3) and blunt abdominal trauma (2). Pseudocyst mean size was 9,8cm (range 5,3-13,5cm). Only patients presenting pancreatic pseudocyst according to The Revised Atlanta Classification were included in this study. Pseudocysts were treated with EUS-guided cystogastrostomy (8) and cystoduodenostomy (1). Overall recorded outcomes were technical success rate, clinical success rate, minor and major adverse events, mortality and recurrence. The criterion for stent removal was pseudocyst resolution on computed tomography scan. Results: Technical success rate was 100% (6 patients with 2 double-pigtail plastic stents and 3 patients with only one double-pigtail plastic stent). Overall clinical success and image pseudocyst resolution 4 – 6 months after initial drainage was 89% (8/9). Minor adverse events occurred in 3/9 patients (33%): false guidewire path with no clinical consequence, early stent migration and stent occlusion. There were no major events adverses. There was a recurrence in (1/9 patients) and no mortality. Conclusions: We concluded that EUS-guided transmural drainage of pancreatic pseudocyst using plastic double-pigtail stents is a safe procedure, resulting in clinical improvement and pseudocyst resolution in most of the patients.