EUS-guided transesophageal drainage of peripancreatic fluid collections

Background: Although several large series have reported Oil EUS-guided transgastric and transduodenal drainage of peripancreatic fluid collections (PFCs), only commentary on individual cases has been presented on EUS-guided transesophageal drainage of PFCs. Objective: To evaluate the technical Success and safety of EUS-guided transesophageal drainage of PFCs. Design: Observational study. Setting: Tertiary academic referral center. Patients: This study involved 3 Consecutive patients referred for EUS-guided transesophageal drainage of PFCs over a 3-year period. Interventions: The PFCs were accessed via the transesophageal route under EUS-guidance by using a 19-gauge needle. After a 0.035-inch guidewire was passed into the PFC, and the transmural tract was dilated to 6 mm, a transmural stent and/or drainage catheter was deployed. Main Outcome Measurements: Evaluation of the technical and treatment Success and safety profile of EUS-guided transesophageal drainage of PFCs. Results: Three male patients (mean age 57.8 years [range 49-75 years]) underwent EUS-guided transesophageal drainage of PFCs (2 pseudocyst, I abscess) over a 3-year period. The etiology of the PFC was alcohol abuse in 2 patients and postsurgical in 1. The mean size of the PFCs was 7 cm (range 6-8 cm) in its largest dimension. The procedures were technically Successful in all 3 patients, and no complications were encountered. All 3 patients had a Successful treatment outcome. At a mean follow-up period of 24 months (range 12-36 months), all patients were doing well, without any evidence of PFC recurrence. Limitation: Small number of patients. Conclusions: in experienced hands, EUS-guided transesophageal drainage of PFCs is technically feasible and safe and is associated with favorable clinical outcomes. A long-term follow-up With larger numbers of patients is required to determine whether the procedure could be in effective alternative to Surgical cyst-enterostomy or percutaneous drainage techniques.