Treatment of postnecrotic pancreatic pseudocysts with the help of internal endoscopic drainage

Неге we present the results of internal endoscopic drainage of pancreatic pseudocysts in 37 patients. 6 of those underwent duodenocystostomy and 31 had gastrocystostomy. ln the remote period, 34 patients were healed, while in 3 cases recurrent pancreatic cysts were observed.

The following signs were used for orientation when choosing the site of possible pseudocyst puncture: rigidity and protrusion of the stomach ог duodenum wall, with smoothening of the folds and absence of peristaltics, as well as mucous edema, erosions and petechiae. Maximal air inflation allowed а clearer detection of these endoscopic signs.

Minimal-invasive endoscopic internal drainage of pseudocysts into the stomach ог duodenum has several advantages over creating cystodigestive anastomoses by an open operation. However, such interventions require certain conditions, such as clear visualization of the site of cyst fixation to the stomach ог duodenum wall (assessed by endoscopic, ultrasound, СТ and MRI methods) and initial minimal (up to 1 mm) puncture that makes it possible to interrupt the manipulation. This efficient method of treatment, which comblnes minimal invasiveness with visual control and morphological verification of the diagnosis should bе widely applied in clinical practice in the future.