Endoscopic drainage of pancreatic fluid collections: Long‐term outcomes in children. Issue 7 (6th June 2017)

• Record Type: Journal Article
• Authors: Nabi, Zaheer; Lakhtakia, Sundeep; Basha, Jahangeer; Chavan, Radhika; Gupta, Rajesh; Ramchandani, Mohan; Kalapala, Rakesh; Pal, Partha; Darisetty, Santosh; Rao, Guduru Venkat; Nageshwar Reddy, D.
• Is Part Of: Digestive endoscopy. Volume 29:Issue 7(2017)
• Page Start: 790
• Page End: 797
• Publication Date: 2017-06-06
• Subjects: child -- collection -- drainage -- endoscopic ultrasonography -- pancreatitis; Digestive organs -- Diseases -- Periodicals; Digestive organs -- Diseases -- Diagnosis -- Periodicals; Endoscopy -- Periodicals; Digestive System Diseases -- diagnosis -- Periodicals; Digestive System Diseases -- therapy -- Periodicals; Endoscopy -- Periodicals; 616.3
• DOI: 10.1111/den.12884
• Languages: English
• ISSNs: 0915-5635

Abstract

Abstract : Background and Aim: Endoscopic drainage of pancreatic fluid collections (PFC) is the standard of care in adult patients. The literature is limited in children. In the present study, we aim to evaluate the safety and long‐term efficacy of endoscopic ultrasound (EUS)‐guided drainage of PFC in children. Methods: Data of all children (<18 years) with PFC who underwent EUS‐guided drainage with plastic stents were analyzed retrospectively for technical feasibility, clinical efficacy and adverse events (AE). Results: Thirty children (boys 22, girls 8) with PFC underwent EUS drainage (January 2013 to June 2016). Mean age of children was 13.07 ± 3.41 years (5–17 years). Majority of children had idiopathic pancreatitis (23), followed by trauma‐related (6) and gallstone‐related pancreatitis (1). Of 30 PFC, 13 (43.3%) and 17 (56.7%) were classified as pseudocyst and walled‐off necrosis, respectively. Median size of PFC was 95 mm (61–175). EUS drainage was successfully completed in 29 children (technical success 96.7%). Clinical success was achieved in 28/30 (93.3%) children. AE included perforation (2), major bleed (1), minor bleed (2), stent migration (4) and readmission as a result of hematemesis (1). Imaging revealed disconnected pancreatic duct in nine, ductal leak in two and stricture in one child. Cystogastric stents were left in situ in children with disconnected duct. At median follow up of 829 days (150–1230), two recurrences of PFC were noticed. Conclusions: EUS‐guided drainage using plastic stents is safe and effective in children with PFC. Cystogastric plastic stents can be left safely long term. However, more studies with larger sample sizes are required.