The Effect Analysis Of Endoscopic Ultrasound-guided Transgastric Drainage Of Pancreatic Pseudocysts

Objective: To evaluate the efficacy of endoscopic ultrasound(EUS)guided transgastric drainage of pancreatic pseudocysts(PPC)and the efficacy and safety of this technique without X-ray monitoring.Methods:1.A retrospective analysis was performed on 24 patients with pancreatic pseudocysts who underwent EUS-guided transgastric drainage from October 2013 and December2018 in the Second Hospital of Hebei Medical University.24 patients(17males and 7 females,age from 26 to 82)were diagnosed as pancreatic pseudocyst by abdominal ultrasound or CT,There were 19 cases of X-ray monitoring and 5 cases of non-x-ray monitoring.2.EUS examination was performed first by physicians experienced in endoscopic ultrasonography,and EUS-guided transgastric drainage was performed further in eligible patients.3.Postoperative routine treatment including fasting water,antibiotics,acid inhibition,nutritional support,observing the patients vital signns and discomfort such as fever,abdominal pain,as well as short-term complicat-ions including bleeding,perforation and infection.4.Regular follow-up of patients to understand the mid-term,long-term complications,the treatment effect and whether recurrence.Results:1.Puncture condition: among the 24 patients,the puncture was successful in 23 cases,including 18 cases with X-ray monitoring,5 cases without X-ray monitoring and 1 case puncture unsuccessful.The overall puncture success rate was 95.8%(23/24),the puncture success rate with X-ray monitoring was 94.7%(18/19),and the puncture success rate without X-ray monitoring was 100%(5/5).2.Complications:4 postoperative infections,All the 4 cases were monitored by X-ray.There were no perforation,hemorrhage,and stet occlusion.The overall complication rate was 17.4%(4/23),including 22.2%(4/18)with X-ray monitoring and 0%(0/5)without X-ray monitoring.3.There was no significant difference in X-ray monitoring.There was no statistically significant difference in X-ray monitoring,cyst size,cyst site,cyst separation and complications(P>0.05).4.Follow-up results: 1 case was lost to follow-up(with X-ray monitoring),2 cases were relapsed(both with X-ray monitoring),1 case was treated failure(with X-ray monitoring),the overall treatment success rate was 95.5%(21/22),the treatment success rate with X-ray monitoring was 94.1%(16/17),and the treatment success rate without X-ray monitoring was 100%(5/5).The overall recurrence rate was 9.1%(2/22),11.8%(2/17)with X-ray monitoring and 0%(0/5)without X-ray monitoring.There were no deaths.Conclusion:1.This study observed the puncture success rate,treatment success rate,incidence of complications,recurrence rate and other indicators of EUS-guided transgastric drainage in the treatment of PPC,and considered that this treatment method is safe,effective and minimally invasive.2.In addition,this technology is safe and effective without X-ray monitoring,reducing radiation hazards and making treatment more convenient and feasible.