BACKGROUND Endoscopic ultrasound is seldom available at paediatric centres; therefore drainage of pancreatic pseudocysts in children has traditionally been achieved by surgery. OBJECTIVE This study assessed the feasibility and safety of performing image-guided internal drainage of pancreatic pseudocysts with a flanged self-expanding covered nitinol pancreatic pseudocyst drainage stent. MATERIALS AND METHODS We conducted a retrospective case note review of children undergoing image-guided cystogastrostomy at two paediatric hospitals. Percutaneous access to the stomach was achieved via an existing gastrostomy tract or image-guided formation of a new tract. Under combined ultrasound, fluoroscopic or cone-beam CT guidance the pancreatic pseudocysts were punctured through the posterior wall of the stomach. A self-expanding covered nitinol stent was deployed to create a cystogastrostomy opening. RESULTS Image-guided cystogastrostomy was performed in 6 children (4 male; median age 6 years, range 46 months to 15 years; median weight 18 kg, range 13.8-47 kg). Two children had prior failed attempts at surgical or endoscopic drainage. Median maximum cyst diameter was 11.5 cm (range 4.7-15.5 cm) pre-procedure. Technical success was 100%. There were no complications. There was complete pseudocyst resolution in five children and a small (2.1-cm) residual pseudocyst in one. Pseudocyst-related symptoms resolved in all children. CONCLUSION Pancreatic pseudocyst drainage can be successfully performed in children by image-guided placement of a cystogastrostomy stent. In this cohort of six children there were no complications.

中文翻译：

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影像引导下的膀胱造瘘术和支架置入术治疗小儿胰腺假性囊肿。

背景技术在儿科中心很少可以使用内窥镜超声检查。因此，小儿胰腺假性囊肿的引流传统上是通过手术实现的。目的本研究评估了法兰式自膨盖镍钛合金胰腺假性囊肿引流支架进行图像引导的胰腺假性囊肿内部引流的可行性和安全性。材料和方法我们对两家儿科医院接受影像引导的膀胱造口术的儿童进行了回顾性病例笔记审查。通过现有的胃造口道或图像引导下的新道形成，可经皮进入胃。在超声，荧光透视或锥形束CT引导下，将胰腺假性囊肿穿入胃后壁。部署自膨胀的覆盖镍钛合金支架以创建膀胱造口术开口。结果对6名儿童（4名男性；中位年龄6岁，范围46个月至15岁；中位体重18千克，范围13.8-47千克）进行了影像引导的膀胱造口术。有两个孩子先前在外科手术或内窥镜引流手术中失败。术前最大囊肿直径中位数为11.5 cm（范围4.7-15.5 cm）。技术成功率为100％。没有并发症。五名儿童完全假性囊肿消退，其中一个小（2.1厘米）残留假性囊肿。假性囊肿相关症状在所有儿童中均得到解决。结论通过影像引导置入膀胱造口术支架可以成功地在儿童中进行胰腺假性囊肿引流。在这六个孩子的队列中，没有并发症。