Endoscopic Drainage of Giant Pancreatic Pseudocysts Using Both Lumen-Apposing Metal Stent and Plastic Stent: A Report of Two Cases and Review of the Current Literature
Table 2
Characteristics of the 24 most reported giant pancreatic pseudocysts.
Variable
Value
Age
Mean: 50.4 years, range: 16–81
Male : female ratio
1 : 0.5
Cause
Acute pancreatitis
18/23 (78%)
Chronic pancreatitis
4/23 (17.4%)
Trauma
1/23 (4.3%)
Clinical presentation
Time of pseudocyst presentation after acute pancreatitis
Mean: 7 weeks, range: 3–20 weeks
Abdominal pain
20/22 (91%)
Abdominal distention
7/22 (32%)
Abdominal mass
5/22 (22.7%)
Anorexia
4/22 (18%)
Early satiety
4/22 (18%)
Weight loss
3/22 (13.6%)
Vomiting
2/22 (9%)
Fever
2/22 (9%)
Laboratory investigations
Elevated WBC
4/15 (26%)
Elevated amylase or lipase
16/16 (100%)
Normal CEA and CA19-9
8/8 (100%)
Diagnosis
Abdominal CT scan
22/24 (92%)
Abdominal US
1/24 (4%)
Diagnostic laparoscopy
1/24 (4%)
Cyst size on CT or US (largest dimension)
Mean: 16.7 cm (10–35 cm)
Management
(1) EUS-guided drainage (14 cases)
Time for stent removal after EUS
Mean: 5.8 weeks, range: 2–9 weeks
Types of stents used
Metallic
4/13
Plastic (double pigtail)
5/13
Both
4/13
Complications
Recurrence of the pseudocyst
5/14 need second drainage (35%), and only 1 case needs third drainage (7%)
