EUS-guided Cystgastrostomy and Direct Endoscopic Necrosectomy

What is Acute Pancreatitis?

Acute pancreatitis (AP) is the most common GI disease that results in hospitalization for patients.  AP (inflammation of the pancreas) is often caused by gallstones or alcohol consumption and can occasionally be severe and even fatal for patients.  When a patient develops AP, the inflammation around their pancreas can result in symptom of nausea, abdominal pain, and lack of appetite.

What is a Pancreatic Fluid Collection (PFC)?

One common complication of AP is the development of PFCs inside the abdomen as a result of the inflammation in the pancreas.  These PFCs can result in infection, pain, nausea, inability to eat and possibly death.   These fluid collections can be very small (<3cm) or develop into extremely large collections (>20cm) that start pushing on adjacent organs.

How can EUS-guided Cystgastrostomy help with PFCs?

Conventionally these fluid collections have been managed surgically requiring invasive morbid surgical dissections and debridements with potential drains exiting the patient’s skin.  However now with endoscopic ultrasound technology, (see endoscopic ultrasound) we can now treat and cure these lesions from completely inside the body.  Specially designed stents can be placed through the stomach or intestines directly into PFCs to drain collections back into the body with almost no pain to the patient.

Is EUS-guided cystgastrostomy a surgical procedure?

No, this is a completely endoscopic procedure that does not involve making any cuts into the patient’s skin.  All the intervention is from inside the body.

Does EUS-guided cystgastrostomy work?

Yes!  Well-designed clinical trials show that EUS-guided cystgastrostomy works as well as surgery, is less costly, and results in much shorter recovery times.

What is Endoscopic Necrosectomy?

Occasionally PFCs can contain solid debris in addition to liquid fluid.  This solid debris can become infected or be difficult to drain out.  Thus an endoscope can be directed through specially designed stents placed during EUS-directed cystgastrostomy to clean out the debris (necrosis).  This technique is called endoscopic necrosectomy. Endoscopic therapy is quickly becoming the first line therapy for management of PFCs and necrosis.

EUS-guided Cystgastrostomy in Dallas, Tx

Are you interested in learning more about EUS-guided cystgastrostomy and necrosectomy, or other treatment options? We invite you to contact us to learn more. Dr. Prashant Kedia is a therapeutic endoscopist and gastroenterologist serving patients in the Dallas-Fort Worth area and beyond. Call today to schedule an appointment at (214) 941-6891.

Eus-Guided Cystgastrostomy

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