Advertisement

Surgical Endoscopy

, Volume 26, Issue 11, pp 3320–3323 | Cite as

Endoscopic ultrasound (EUS)-guided pseudocyst drainage as a one-step procedure using a novel multiple-wire insertion technique (with video)

  • Mouen A. KhashabEmail author
  • Anne Marie Lennon
  • Vikesh K. Singh
  • Anthony N. Kalloo
  • Samuel A. Giday
Dynamic Manuscript

Abstract

Background

The EUS 2008 working group considered the development of equipment and methods to minimize the need for exchanging accessories and to facilitate insertion of multiple transmural stents during endoscopic ultrasound (EUS)-guided pseudocyst drainage as an important advance for therapeutic EUS. The authors aimed to describe their experience with EUS-guided pseudocyst drainage using a novel multiple-wire insertion technique facilitated by the double-lumen biliary cytology brush catheter.

Methods

The study enrolled 10 symptomatic patients undergoing EUS-guided pseudocyst drainage. The EUS-guided pseudocyst drainage was performed as a one-step procedure using graded catheter and balloon dilation of the cystgastrostomy tract and a novel multiple-wire insertion technique facilitated by a modified double-lumen biliary cytology brush catheter. The main outcome measured was technical success.

Results

In this study, 10 patients with 11 pseudocysts underwent a EUS-guided pseudocyst using the novel multiple-wire insertion technique. Technical success, defined as successful achievement of access and drainage of pseudocysts, was achieved in all cases (100 %) with no procedural complications. Clinical success was achieved in all cases with complete resolution of pseudocysts.

Conclusions

The novel method of using a modified double-lumen biliary cytology brush catheter allows for a simple and safe one-step EUS-guided drainage of pseudocysts.

Keywords

Double-lumen biliary cytology brush catheter Endoscopic ultrasound Multiple-wire insertion Pseudocyst drainage 

Notes

Acknowledgement

Mouen A. Khashab is a consultant for Boston Scientific, and Samuel Giday is a consultant for Cook Medical. Anthony Kalloo is a founding member, equity holder and consultant for Apollo Endosurgery.

Disclosures

Anne Marie Lennon and Vikesh K. Singh have no conflicts of interest or financial ties to disclose.

Supplementary material

Supplementary material 1 (MPG 19678 kb)

References

  1. 1.
    Bhattacharya D, Ammori BJ (2003) Minimally invasive approaches to the management of pancreatic pseudocysts: review of the literature. Surg Laparosc Endosc Percutan Tech 13:141–148PubMedCrossRefGoogle Scholar
  2. 2.
    Bradley EL III, Howard TJ, van Sonnenberg E, Fotoohi M (2008) Intervention in necrotizing pancreatitis: an evidence-based review of surgical and percutaneous alternatives. J Gastrointest Surg 12:634–639PubMedCrossRefGoogle Scholar
  3. 3.
    Varadarajulu S, Christein JD, Tamhane A, Drelichman ER, Wilcox CM (2008) Prospective randomized trial comparing EUS and EGD for transmural drainage of pancreatic pseudocysts (with videos). Gastrointest Endosc 68:1102–1111PubMedCrossRefGoogle Scholar
  4. 4.
    Fockens P, Johnson TG, van Dullemen HM, Huibregtse K, Tytgat GN (1997) Endosonographic imaging of pancreatic pseudocysts before endoscopic transmural drainage. Gastrointest Endosc 46:412–416PubMedCrossRefGoogle Scholar
  5. 5.
    Seewald S, Ang TL, Kida M, Teng KY, Soehendra N (2009) EUS 2008 working group document: evaluation of EUS-guided drainage of pancreatic-fluid collections (with video). Gastrointest Endosc 69:S13–S21PubMedCrossRefGoogle Scholar
  6. 6.
    Varadarajulu S, Tamhane A, Blakely J (2008) Graded dilation technique for EUS-guided drainage of peripancreatic fluid collections: an assessment of outcomes and complications and technical proficiency (with video). Gastrointest Endosc 68:656–666PubMedCrossRefGoogle Scholar
  7. 7.
    Seewald S, Thonke F, Ang TL et al (2006) One-step, simultaneous double-wire technique facilitates pancreatic pseudocyst and abscess drainage (with videos). Gastrointest Endosc 64:805–808PubMedCrossRefGoogle Scholar
  8. 8.
    Evans JA, Conway JD, Mishra G (2010) A novel method for performing multiple wire insertions during endoscopic cyst gastrostomy. Gastrointest Endosc 71:612–614PubMedCrossRefGoogle Scholar
  9. 9.
    Ang TL, Teo EK, Fock KM (2008) EUS-guided drainage of infected pancreatic pseudocyst: use of a 10-F Soehendra dilator to facilitate a double-wire technique for initial transgastric access (with videos). Gastrointest Endosc 68:192–194PubMedCrossRefGoogle Scholar
  10. 10.
    Jansen JM, Hanrath A, Rauws EA, Bruno MJ, Fockens P (2007) Intracystic wire exchange facilitating insertion of multiple stents during endoscopic drainage of pancreatic pseudocysts. Gastrointest Endosc 66:157–161PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Mouen A. Khashab
    • 1
    Email author
  • Anne Marie Lennon
    • 1
  • Vikesh K. Singh
    • 1
  • Anthony N. Kalloo
    • 1
  • Samuel A. Giday
    • 1
  1. 1.Division of Gastroenterology and Hepatology, Department of MedicineThe Johns Hopkins Medical InstitutionsBaltimoreUSA

Personalised recommendations