Clinical outcomes following endoscopic transmural drainage for pancreatic pseudocyst versus walled-off necrosis

Objective To compare the effect of endoscopic transmural drainage for pancreatic pseudocyst versus walled-off necrosis (WON). Methods From 2007 to 2017,patients with pancreatic pseudocyst or WON admitted to our department who received endoscopic transmural drainage were all included.Technical success rate,treatment success rate,times of endoscopic treatment,number of stents placed,length of hospital stay,adverse events,recurrence,and follow-up length for pseudocyst or WON disappeared were recorded and compared. Results Totally 23 patients were included in this study,13 patients (6 males and 7 females with average age of 48 years) diagnosed as pancreatic pseudocyst and 10 patients (8 males and 2 females with average age of 39 years) diagnosed as WON.There was no significant difference in technical success rate,treatment success rate,times of endoscopic treatment,additional nasocystic drainage and endoscopic necrosectomy between the two groups.While the total number of stents needed in pancreatic pseudocyst group was less than that in WON group (MdMin,Max:10,3 vs 20,8,P=0.031).Meanwhile,adverse events,adverse events managements,recurrence,subsequent treatment and follow-up length for lesions disappeared had no statistical difference between the two groups;however,the length of hospital stay in pancreatic pseudocyst group was less than that in WON group (MdMin,Max:126.5,22.5 d vs 22.513.75,60.5 d,P=0.042). Conclusion EUS-guided endoscopic transmural drainage for treatment of WON is associated with more stents and longer hospital stay when compared with pancreatic pseudocyst.