Experience of combined endoscopic percutaneous stenting with ultrasound guidance for drainage of pancreatic pseudocycts

The therapeutic options for treatment of pancreatic pseudocysts are numerou s. We report our experience of combined endoscopic and ultrasound guided pe rcutaneous stenting for pancreatic pseudocysts. Data were prospectively col lected for 20 consecutive patients. All patients had undergone a standard t echnique of combined endoscopic and ultrasound guided percutaneous placemen t of double J stents, between a pancreatic pseudocyst and the stomach. Pati ents age ranged between 25 and 84 years. Thirteen of the pseudocysts were d ue to acute pancreatitis and 7 were due to chronic pancreatitis. The durati on of the combined procedure was mean 50 min (range 30-95 min). The length of hospital stay was mean 5 days (range 2-77 days). Only two patients suffe red postoperative complications; one was re-admitted 2 weeks following sten ting with acute cholecystitis, the other suffering a perforated duodenal ul cer 3 weeks after stenting. There were two failures early in the series, bo th due to stent migration, these stents were of a small size, (4.7 French). Following this the stent size was increased to at least 7 French, no furth er failures occurred. There was no operative mortality for the series. Foll ow-up ranged between 6 months and 5 years. We conclude that a combined perc utaneous and endoscopic cyst-gastrostomy stent is a safe and effective trea tment for patients with suitably placed pseudocysts.