TRANSMURAL DRAINAGE OF PANCREATIC FLUID COLLECTIONS WITHOUT ELECTROCAUTERY USING THE SELDINGER TECHNIQUE

Background: Complications of endoscopic transmural drainage of pancrea tic fluid collections arise from entry through the gastrointestinal wa ll. We describe transmural drainage of these collections using the Sel dinger technique without electrocautery. Methods: From January 1995 to September 1997, we attempted endoscopic transmural drainage of 94 con secutive pancreatic fluid collections without EUS guidance (needle-kni fe entry in 51, Seldinger entry technique in 43). Success of entry and complications were compared. Results: Successful entry was achieved i n 95.3% using the Seldinger technique and 92.1% using the needle-knife entry technique (p = NS). Complications of bleeding and perforation w ere seen in 4.6% of patients in the Seldinger group and 15.7% in the n eedle-knife entry group. Conclusions: The Seldinger technique of endos copic transmural drainage of pancreatic fluid collections appears effe ctive and safer than entry using the needle-knife. Collections as smal l as 3 cm in diameter can be entered using the Seldinger technique wit hout EUS guidance.