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Endoscopic Ultrasoundguided Drainage of Pancreatic Fluid Collections in Children

Ramesh, Jayapal; Bang, Ji Y.; Trevino, Jessica; Varadarajulu, Shyam

Journal of Pediatric Gastroenterology & Nutrition:
doi: 10.1097/MPG.0b013e318267c113
Original Articles: Gastroenterology
Abstract

Background and Objective: Although endoscopic ultrasound (EUS)–guided drainage of pancreatic fluid collections (PFCs) has evolved as the standard of care in adults, its role as a single-step drainage modality in children is unclear. The aim of the present study was to evaluate the efficacy and safety of single-step EUS-guided drainage of PFCs in children.

Methods: This is a retrospective study of all of the children who underwent single-step EUS-guided drainage of PFCs during a 4-year period at 1 institution. An endoscopic retrograde cholangiopancreatography was attempted before EUS-guided drainage to evaluate the pancreatic duct and bridge any ductal disruption.

Results: A total of 7 children (4 boys; mean age 8.4 years [standard deviation 2.1]) underwent EUS-guided drainage of PFCs. The etiology was blunt abdominal trauma in 5, hereditary pancreatitis in 1, and idiopathic pancreatitis in 1. Both technical and treatment success rates were 100% with median procedural duration of 12 minutes (interquartile range 12–20 minutes). Two patients underwent repeat EUS-guided drainage due to lack of adequate resolution of PFC on follow-up computed tomography. There were no immediate or delayed complications. At a median follow-up of 1033 days (interquartile range 193–1167 days), all of the children were doing well with no PFC recurrence.

Conclusions: Single-step EUS-guided drainage of PFC in children is technically feasible, safe, clinically effective, and when available, should be the first-line treatment modality.

Author Information

Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, Alabama.

Address correspondence and reprint requests to Jayapal Ramesh, MD, Assistant Professor, Division of Gastroenterology and Hepatology, University of Alabama in Birmingham, BDB 389, 1808 7th Avenue South, Birmingham, AL 35294 (e-mail: j1ramesh@gmail.com).

Received 20 March, 2012

Accepted 18 June, 2012

The authors report no conflicts of interest.

Copyright 2013 by ESPGHAN and NASPGHAN