Endoscopic transpapillary drainage of infected pancreatic pseudocyst complicating pancreatitis,a report of 18 cases

Objective To evaluate the effectiveness of endoscopic transpapillary drainage in the treatment of infected pancreatic pseudocyst complicating pancreatitis.Methods The data of 18 cases of pancreatitis with infected pancreatic pseudocyst having undergone endoscopic transpapillary drainage from Jan.2004 to Jun.2006 were retrospectively analyzed.All patients were diagnosed and then checked postoperatively by endoscopic retrograde cholangiopancreatography(ERCP) and CT.All patients were treated by endoscopic sphincterectomy(EST),endoscopic pancreatic sphincterectomy(EPS),or endoscopic nose-pancreatic pseudocysts drainage(ENPPD).Extraction of pancreatic duct stones and dilatation of pancreatic duct stricture were performed selectively.Results During the treatment,removal of pancreatic stones was performed in 6 cases.Pancreatic duct dilatation was performed in 9 cases with pancreatic duct narrowing,and 8 cases received pancreatic stents drainage.Postoperatively,clinical symptoms were evidently alleviated in 18 patients,and with a large amount of purulent pancreatic fluid drained.Symptom of infection,including abdominal pain and fever,were within 48 hours after drainage,and were controlled within 1 week.Pancreatic pseudocysts disappeared in 16 cases,and conspicuously shrank in 2 patients.Pancreatic function recovered gradually following endoscopic transpapillary nose-pancreatic pseudocyst drainage.Conclusions In the treatment of pancreatitis with infected pancreatic pseudocyst,endoscopic transpapillary nose-pancreatic pseudocysts drainage is a preferred method for its safety,less trauma,lower expenditure,convenient and conspicuous curative effect.