Endoscopic Ultrasound-guided Drainage of Pancreatic Fluid Collections in children.
ABSTRACT BACKGROUND:: Although EUS-guided drainage of pancreatic fluid collections (PFCs) has evolved as the standard of care in adults, its role as a single-step drainage modality in children is unclear. OBJECTIVE:: To evaluate the efficacy and safety of single-step EUS-guided drainage of PFCs in children. MATERIALS AND METHODS:: This is a retrospective study of all children who underwent single-step EUS-guided drainage of PFCs over a 4-year period at one institution. An ERCP was attempted prior to EUS-guided drainage to evaluate the pancreatic duct and bridge any ductal disruption. RESULTS:: Seven children (boys = 4; mean age 8.4yrs [standard deviation = 2.1]) underwent EUS-guided drainage of PFCs. The etiology was blunt abdominal trauma in 5, hereditary pancreatitis in 1 and idiopathic pancreatitis in 1. Both technical and treatment success rates were 100% with median procedural duration of 12 minutes (IQR = 12-20 minutes). Two patients underwent repeat EUS-guided drainage due to lack of adequate resolution of PFC on follow-up CT. There were no immediate or delayed complications. At a median follow-up of 1033 days (IQR = 193 - 1167 days), all children were doing well with no PFC recurrence. CONCLUSION:: Single-step EUS-guided drainage of PFC in children is technically feasible, safe, clinically effective and when available should be the first-line treatment modality.