PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

Study examines endoscopic ultrasound-guided drainage of pancreatic pseudocysts

2013-10-22
(Press-News.org) Contact information: Anne Brownsey
abrownsey@asge.org
630-570-5635
American Society for Gastrointestinal Endoscopy
Study examines endoscopic ultrasound-guided drainage of pancreatic pseudocysts DOWNERS GROVE, Ill. – October 21, 2013 – Researchers report that in patients with pseudocysts with viscous debris-laden fluid, endoscopic ultrasound-guided drainage by using a combination of a nasocystic drain and transmural stents improves clinical outcomes and lowers the stent occlusion rate compared with those who underwent drainage via stents alone. The study appears in the October issue of GIE: Gastrointestinal Endoscopy, the monthly peer-reviewed scientific journal of the American Society for Gastrointestinal Endoscopy (ASGE).

A pancreatic pseudocyst consists of a localized fluid collection that is within or adjacent to the pancreas and is sealed in a fibrous wall of reactive tissue. Pseudocysts develop in 10 percent to 20 percent of patients with acute pancreatitis (inflammation of the pancreas) and are present in 20 percent to 40 percent of patients with chronic pancreatitis. Indications for drainage of the pseudocyst include persistent intra-abdominal symptoms (ie, abdominal pain, early satiety, nausea and vomiting), cyst-related adverse events (biliary obstruction or infection), and/or a rapid increase in cyst size. The management of pseudocysts traditionally has been surgical. However, surgical management has been associated with a 35 percent adverse-event rate and mortality of 10 percent. Endoscopic ultrasound-guided transmural drainage is a minimally invasive method for the management of pseudocysts. Clinical trials have demonstrated that EUS-guided drainage is as effective as surgery, causes fewer adverse events, and is more cost-effective compared with surgery.

Most studies on the endoscopic treatment of pseudocysts have evaluated the use of one or more endoprostheses (hollow stents or tiny tubes that are inserted into the pseudocyst to allow drainage into the stomach or duodenal lumen) alone for transgastric or transduodenal drainage. EUS-guided drainage has now been recognized as the standard procedure for the management of symptomatic pancreatic pseudocysts. However, debris within the pseudocyst may impair the outcome of endoscopic drainage by leading to premature stent occlusion (blockage). A recent study demonstrated that pancreatic pseudocyst drainage with both endoprosthesis (stents) and nasocystic (from the nose into the cyst) drainage is safe and associated with a high success rate.

Endoscopic ultrasound (EUS) uses a flexible endoscope which has a small ultrasound device built into the end and can be used to see the lining of the esophagus, stomach, small bowel, or colon. The ultrasound component produces sound waves that create visual images of the digestive tract which extend beyond the inner surface lining and also allows visualization of adjacent organs. EUS can also be used to diagnose and treat diseases of the pancreas, bile duct and gallbladder when other tests are inconclusive, and EUS can be used to determine the stage of cancers.

"We hypothesize that the placement of an additional nasocystic drain alongside the transmural stents may be particularly useful to facilitate irrigation of the cyst cavity when the fluid to be drained has a significant amount of debris. There is currently no clinical trial to evaluate the aforementioned hypothesis. The primary aim of this study was to compare the short-term and long-term clinical outcomes of EUS-guided pseudocyst drainage with and without nasocystic drainage for the management of pancreatic pseudocysts with viscous solid debris-laden fluid. Our secondary outcomes were to evaluate procedure-related adverse events and reintervention in the study cohort," said study lead author Ali A. Siddiqui, MD, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania. "We found that EUS-guided drainage of pseudocysts with viscous solid debris-laden fluid via a nasocystic drain alongside transmural stents resulted in a lower stent occlusion rate and better clinical outcomes when compared with drainage via transmural stents alone."

Methods

The endoscopic database at Thomas Jefferson University Hospital was searched for all patients who had undergone EUS-guided drainage of a pancreatic pseudocyst with "viscous solid debris-laden fluid" between October 2000 and January 2012. All cysts were diagnosed by CT or magnetic resonance imaging. The indications for pseudocyst drainage were symptomatic, rapidly enlarging, and/or infected pseudocysts. The study examined consecutive patients with pancreatic pseudocysts managed by EUS-guided drainage and compared those who underwent drainage via nasocystic drains alongside stents versus those who underwent drainage via transmural stents only. The primary outcomes were short-term success and long-term success of the procedures. The secondary outcomes were procedure-related adverse events and re-intervention. The final analysis included 88 patients who all underwent endoscopy by three experienced staff gastroenterologists.

Results

The patients with viscous solid debris-laden fluid whose pseudocysts were drained by both stents and nasocystic tubes had a three times greater short-term success rate compared with those who had drainage by stents alone. On 12-month follow-up, complete resolution of pseudocysts with debris drained via stents alone was less (58 percent) compared with those with debris who underwent drainage via nasocystic drains alongside stents (79 percent). The rate of stent occlusion was higher in cysts with debris drained by stents alone (33 percent) compared with those drained via nasocystic drains alongside stents (13 percent).

The researchers concluded that EUS-guided drainage of pancreatic pseudocysts with viscous solid debris-laden fluid via a nasocystic drain alongside transmural stents resulted in a lower stent occlusion rate and better clinical outcomes when compared with drainage via transmural stents alone. They hypothesized that the presence of solid debris within a pseudocyst may require early saline solution irrigation via a nasocystic tube to achieve adequate drainage and prevent stent occlusion. They recommended a prospective multi-center study to confirm these findings.

###

About the American Society for Gastrointestinal Endoscopy

Since its founding in 1941, the American Society for Gastrointestinal Endoscopy (ASGE) has been dedicated to advancing patient care and digestive health by promoting excellence and innovation in gastrointestinal endoscopy. ASGE, with more than 12,000 members worldwide, promotes the highest standards for endoscopic training and practice, fosters endoscopic research, recognizes distinguished contributions to endoscopy, and is the foremost resource for endoscopic education. Visit http://www.asge.org and http://www.screen4coloncancer.org for more information and to find a qualified doctor in your area.

About Endoscopy

Endoscopy is performed by specially-trained physicians called endoscopists using the most current technology to diagnose and treat diseases of the gastrointestinal tract. Using flexible, thin tubes called endoscopes, endoscopists are able to access the human digestive tract without incisions via natural orifices. Endoscopes are designed with high-intensity lighting and fitted with precision devices that allow viewing and treatment of the gastrointestinal system.

END



ELSE PRESS RELEASES FROM THIS DATE:

Intervention helps older adults prepare for emergencies

2013-10-22
Intervention helps older adults prepare for emergencies Program helps at-risk seniors in rural communities plan ahead COLUMBIA, Mo. – According to the Centers for Disease Control and Prevention, one in three adults age 65 and older falls at least once ...

UCSB anthropologist studies the evolutionary benefit of human personality traits

2013-10-22
UCSB anthropologist studies the evolutionary benefit of human personality traits (Santa Barbara, Calif.) –– Bold and outgoing or shy and retiring –– while many people can shift from one to the other as circumstances warrant, in general ...

New report focuses on interface of digital humanitarian groups and government

2013-10-22
New report focuses on interface of digital humanitarian groups and government Looks at best ways to take advantage of new sources of information to improve disaster response A new report ...

Contact lens discomfort: What is it, why does it occur and how can it be treated?

2013-10-22
Contact lens discomfort: What is it, why does it occur and how can it be treated? Workshop report offers framework for getting answers BOSTON, MA, October 21, 2013 – Contact lens discomfort (CLD) may be the leading cause of patient ...

Small changes in ag practices could reduce produce-borne illness

2013-10-22
Small changes in ag practices could reduce produce-borne illness Researchers from Cornell University have identified some agricultural management practices in the field that can either boost or reduce the risk of contamination in produce from two major foodborne ...

A chameleon in the physics lab

2013-10-22
A chameleon in the physics lab Looking cooler when heated, a thin coating tricks infrared cameras Cambridge, Mass. – October 21, 2013 – Active camouflage has taken a step forward at the Harvard School of Engineering and Applied Sciences (SEAS), with a new coating ...

Low vitamin D levels raise anemia risk in children, Hopkins-led study shows

2013-10-22
Low vitamin D levels raise anemia risk in children, Hopkins-led study shows Low levels of the "sunshine" vitamin D appear to increase a child's risk of anemia, according to new research led by investigators at the Johns Hopkins Children's Center. The study, ...

Atomically thin device promises new class of electronics

2013-10-22
Atomically thin device promises new class of electronics Tunable electrical behavior not previously realized in conventional devices As electronics approach the atomic scale, researchers are increasingly successful at developing atomically thin, virtually two-dimensional ...

Study identifies safe delivery system for tricky yet potent anti-cancer cancer compound

2013-10-22
Study identifies safe delivery system for tricky yet potent anti-cancer cancer compound Researchers at the University of California, San Diego School of Medicine have discovered a way to effectively deliver staurosporine (STS), a powerful anti-cancer compound ...

Single mutation gives virus new target

2013-10-22
Single mutation gives virus new target PROVIDENCE, R.I. [Brown University] — In a new study published online in the journal PLOS Pathogens, an international team of scientists showed that by swapping a single amino acid they could change the sugar to which ...

LAST 30 PRESS RELEASES:

Brain stimulation can boost math learning in people with weaker neural connections

Inhibiting enzyme could halt cell death in Parkinson’s disease, study finds

Neurotechnology reverses biological disadvantage in maths learning

UNDER EMBARGO: Neurotechnology reverses biological disadvantage in maths learning

Scientists target ‘molecular machine’ in the war against antimicrobial resistance

Extending classical CNOP method for deep-learning atmospheric and oceanic forecasting

Aston University research: Parents should encourage structure and independence around food to support children’s healthy eating

Thunderstorms are a major driver of tree death in tropical forests

Danforth Plant Science Center adds two new faculty members

Robotic eyes mimic human vision for superfast response to extreme lighting

Racial inequities and access to COVID-19 treatment

Residential segregation and lung cancer risk in African American adults

Scientists wipe out aggressive brain cancer tumors by targeting cellular ‘motors’

Capturability distinction analysis of continuous and pulsed guidance laws

CHEST expands Bridging Specialties Initiative to include NTM disease and bronchiectasis on World Bronchiectasis Day

Exposure to air pollution may cause heart damage

SwRI, UTSA selected by NASA to test electrolyzer technology aboard parabolic flight

Prebiotics might be a factor in preventing or treating issues caused by low brain GABA

Youngest in class at higher risk of mental health problems

American Heart Association announces new volunteer leaders for 2025-26

Gut microbiota analysis can help catch gestational diabetes

FAU’s Paulina DeVito awarded prestigious NSF Graduate Research Fellowship

Champions for change – Paid time off initiative just made clinical trials participation easier

Fentanyl detection through packaging

Prof. Eran Meshorer elected to EMBO for pioneering work in epigenetics

New 3D glacier visualizations provide insights into a hotter Earth

Creativity across disciplines

Consequences of low Antarctic sea ice

Hear here: How loudness and acoustic cues help us judge where a speaker is facing

A unique method of rare-earth recycling can strengthen the raw material independence of Europe and America

[Press-News.org] Study examines endoscopic ultrasound-guided drainage of pancreatic pseudocysts