Experience of transmural endoscopic drainage in treatment of pancreatic pseudocysts

Abstract

Objective. To evaluate the possibilities of transmural endoscopic drainage in the treatment of postnecrotic pancreatic pseudocysts in the immediate and long-term periods. Materials and methods. From 2018 to 2022, a transmural endoscopic drainage method was used in the treatment of 36 patients with pancreatic pseudocysts at Perm Regional Clinical Hospital. The results were evaluated in the immediate postoperative period, 47 months before the removal of the stent and 14 years by the complaints of patients, blood amylase content, the results of ultrasound and CT examination of the abdominal cavity. Results. Two-three days after the endoscopic intervention, the cyst completely disappeared in 30.56 % of patients, decreased by half or more of the diameter in 63.89 % and only in 5.56 % decreased slightly. After 14 years, the absence of cysts was registered in 80 %, small diameter (from 15 to 24 mm) in 10 %. Pancreatic cysts persisted in three patients (10 %). Statistical analysis showed that the wider was the main pancreatic duct and the higher the blood amylase level before transmural endoscopic drainage, the poorer was the treatment result. Conclusions. Transmural endoscopic drainage of pancreatic pseudocysts makes it possible to achieve complete disappearance or significant reduction in the size of pancreatic cysts a year or more after the intervention in 90 % of cases. The clinical result of transmural endoscopic drainage in the treatment of pancreatic pseudocysts depended on the initial width of the main pancreatic duct and the level of blood amylase.