Journal of pediatric gastroenterology and nutrition · 2013
Endoscopic ultrasound-guided drainage of pancreatic fluid collections in children.
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Ramesh Jayapal, Bang Ji Y, Trevino Jessica, Varadarajulu Shyam
Аннотация
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.
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.