nnnnnnnnnnnnnnnnnnnnnnnnnn Original Article nnnnnnnnnnnnnnnnnnnnnnnnnn Study Aims: The purpose of this study is to evaluate a new drainage technique for pancreatic pseudocysts or pancreatic abscesses entirely guided by endoscopic ul- trasound EUS) and using an interventional echo endo- scope with a linear curved array transducer. Patients and Methods: Between July 1996 and Septem- ber 1999, EUS-guided drainage of a pancreatic pseudo- cyst or pancreatic abscess was carried out in 35 patients 26 men, 9 women; mean age 56.7, range 29±69). The mean size of the 35 pancreatic cysts was 7.8cm 4± 12 cm). Pancreatic pseudocysts were located in the head of the pancreas in two cases, in the body in six cases and in the tail in seven cases. On the other hand, the pancreatic abscesses were located in the tail of the pan- creas in 17 cases and in the gastric wall in three cases. The EUS instrument used was the FG 38X endoscope manufactured by Pentax-Hitachi. Results: No major complication occurred except in one case of a pneumoperitoneum, which was managed medically. Placement of the 7-F nasocystic drain was successful in 18/20 cases of pancreatic abscess. Surgery was performed in the two other patients. Concerning the pancreatic pseudocysts, placement of an 8.5-French stent was successful in 10 patients and of a nasopan- creatic drain in five patients. In one case, only a punc- ture-aspiration was performed. One recurrence among the 15 pancreatic pseudocysts and two relapses of the 18 pancreatic abscesses have been observed, over a mean follow-up of 27 months 6±48 months). EUS-guid- ed drainage was successful in 31/35 patients 88.5%); only four patients with pancreatic abscesses underwent surgery. No bleeding occurred during the time of this study. Conclusion: Internal drainage of pancreatic pseudocysts and abscesses exclusively performed with an echo endo- scope is a safe and efficient method which should be evaluated further in larger studies. Introduction Over recent years, the endoscopic drainage of pancreatic pseudocysts has become established. The main risk asso- ciated with endoscopic treatment is hemorrhage 6±10%) [1±3]. Endoscopic ultrasound EUS) with longitudinal scanners has been used for guidance of transmural punc- tures [4±6] and drainage procedures. Using this technique, puncture of cysts under direct visual control is possible even without bulging of the gastric or duodenal wall. The purpose of this study was to evaluate this new technique of drainage for pancreatic pseudocysts or pancreatic abscesses entirely guided by endoscopic ultrasound EUS) and using an interventional echo endoscope with a linear curved ar- ray transducer. Patients and Methods Between July 1996 and September 1999, EUS-guided drainage of pancreatic pseudocyst was carried out in 35 pa- tients 26 men, 9 women; mean age 56.7, range 29±69). For 32/33 patients, gastroscopy did not reveal extrinsic compression allowing selection of the puncture site. A cys- togastrostomy was performed in 33 patients and a cysto- duodenostomy in two patients, for 15 pancreatic pseudo- cysts and 20 pancreatic abscesses. The origin of the pan- creatic pseudocysts was alcoholic chronic pancreatitis in 8 cases, acute pancreatitis caused by biliary stones in 5 cases, and hyperlipidemia in two cases. The origin of the 20 pancreatic abscesses was postoperative acute pancreati- tis in 19 cases and post to endoscopic retrograde cholan- giopancreatography ERCP) in one case. Indications for Endoscopic Ultrasound-Guided Drainage of Pancreatic Pseudocysts or Pancreatic Abscesses Using a Therapeutic Echo Endoscope M. Giovannini, C. Pesenti, A.-L. Rolland, V. Moutardier, J.-R. Delpero Endoscopic Unit, Paoli-Calmettes Institute, Marseilles, France Endoscopy 2001; 33 6): 473±477  Georg Thieme Verlag Stuttgart · New York ISSN 0013-726X 473 Heruntergeladen von: WEST VIRGINIA UNIVERSITY. Urheberrechtlich geschützt.