| Theme |
Advances in Diagnosis and Endoscopic Treatment for Pancreatic and Biliary Lesion |
| Title |
Non-invasive Treatments for Pancreatic Pseudocysts |
| Author |
Osamu Hasebe |
Department of Gastroentarology, Nagano Municipal Hospital |
| Author |
Yasuhide Ochi |
Department of Gastroentarology, Nagano Municipal Hospital |
| Author |
Nobuyuki Tateiwa |
Department of Gastroentarology, Nagano Municipal Hospital |
| Author |
Naoki Tanaka |
Saku Central Hospital |
| Author |
Takeshi Hisa |
Saku Central Hospital |
| Author |
Shinji Okaniwa |
Iida Municipal Hospital |
| [ Summary ] |
Non-invasive treatments for pancreatic pseudocysts consist of percutaneous drainage, endoscopic transpapillary drainage, and endoscopic transmural drainage. Endoscopic transpapillary drainage is performed in cases with pseudocysts communicating with the pancreatic duct. Endoscopic transmural drainage is indicated in other cases presenting extrinsic compression of the gastric or duodenal wall. Although endoscopic transpapillary drainage is an effective and safe procedure, insertion of endoprothesis through the main pancreatic duct stent or extraction of pancreatic stones are sometimes needed after pseudocyst drainage. EUS-guided transmural drainage reduces the risks of bleeding and perforation during drainage procedures. We must pay attention to pseudocyst infection in cases presenting a large quantity of debris in the cystic lumen. Recently, aggressive endoscopic therapy for pancreatic necrosis and pancreatic abscess has been reported and has shown promising results. |