Ker CG. Endoscopic intramural cystogastrostomy for treatment of peripancreatic fluid collection: A viewpoint from a surgeon. World J Gastroenterol 2024; 30(6): 610-613 [PMID: 38463025 DOI: 10.3748/wjg.v30.i6.610]
Corresponding Author of This Article
Chen-Guo Ker, FACS, MD, PhD, Professor of Surgery, Department of General Surgery, E-Da Hospital, I-Shou University, No. 1 Yi-Da Rd, Yanchao District, Kaohsiung 824, Taiwan. ed112739@edah.org.tw
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Letter to the Editor
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Feb 14, 2024; 30(6): 610-613 Published online Feb 14, 2024. doi: 10.3748/wjg.v30.i6.610
Endoscopic intramural cystogastrostomy for treatment of peripancreatic fluid collection: A viewpoint from a surgeon
Chen-Guo Ker
Chen-Guo Ker, Department of General Surgery, E-Da Hospital, I-Shou University, Kaohsiung 824, Taiwan
Author contributions: Ker CG performed literature search and evaluation, and manuscript preparation.
Conflict-of-interest statement: The author declares no conflict of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chen-Guo Ker, FACS, MD, PhD, Professor of Surgery, Department of General Surgery, E-Da Hospital, I-Shou University, No. 1 Yi-Da Rd, Yanchao District, Kaohsiung 824, Taiwan. ed112739@edah.org.tw
Received: October 31, 2023 Peer-review started: October 31, 2023 First decision: December 4, 2023 Revised: December 8, 2023 Accepted: January 16, 2024 Article in press: January 16, 2024 Published online: February 14, 2024
Abstract
Percutaneous or endoscopic drainage is the initial choice for the treatment of peripancreatic fluid collection in symptomatic patients. Endoscopic transgastric fenestration (ETGF) was first reported for the management of pancreatic pseudocysts of 20 patients in 2008. From a surgeon’s viewpoint, ETGF is a similar procedure to cystogastrostomy in that they both produce a wide outlet orifice for the drainage of fluid and necrotic debris. ETGF can be performed at least 4 wk after the initial onset of acute pancreatitis and it has a high priority over the surgical approach. However, the surgical approach usually has a better success rate because surgical cystogastrostomy has a wider outlet (> 6 cm vs 2 cm) than ETGF. However, percutaneous or endoscopic drainage, ETGF, and surgical approach offer various treatment options for peripancreatic fluid collection patients based on their conditions.
Core Tip: Endoscopic transgastric fenestration (ETGF) actually shares the same indications and procedures as surgical cystogastrostomy for the management of pancreatic pseudocysts. From a surgeon’s viewpoint, both ETGF and surgical cystogastrostomy are used for producing a wide outlet orifice for the drainage. Endoscopic ultrasound-guided drainage and necrosectomy or ETGF has a high priority over the surgical approach. However, the surgical approach usually has a better success rate because surgical cystogastrostomy has a wider outlet than ETGF.
