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Retrospective Study
Copyright ©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pharmacol Ther. Mar 5, 2026; 17(1): 112068
Published online Mar 5, 2026. doi: 10.4292/wjgpt.v17.i1.112068
Endoscopic ultrasound-guided pancreatic pseudocyst drainage in pediatric patients
Asma Yaseen, Javeria Salman, Shanil Kadir, Muhammad Asim, Muhammad Umair Tahseen, Noval Zakaria, Abeer Altaf, Naseer Ahmed, Mehreen Siyal, Fahad Kakar, Sajida Qureshi, Saad Khalid Niaz
Asma Yaseen, Javeria Salman, Shanil Kadir, Muhammad Asim, Muhammad Umair Tahseen, Noval Zakaria, Abeer Altaf, Naseer Ahmed, Mehreen Siyal, Fahad Kakar, Sajida Qureshi, Saad Khalid Niaz, Gastroenterology, Sindh Institute of Advanced Endoscopy and Gastroenterology, Karachi 75000, Sindh, Pakistan
Co-corresponding authors: Shanil Kadir and Saad Khalid Niaz.
Author contributions: Yaseen A conceptualized and designed the study, participated in data collection and interpretation, and drafted the initial manuscript; Salman J contributed to the study design, conducted the literature review, and was involved in critical revision of the manuscript for important intellectual content; Kadir S coordinated the data acquisition process and assisted with manuscript editing and formatting; Asim M performed data analysis, contributed to the interpretation of the findings, and assisted in drafting sections of the results and discussion; Tahseen MU carried out the statistical analysis, verified the underlying data, and contributed to the data visualization and figure preparation; Zakaria N participated in the formulation of research objectives and significantly revised the manuscript for methodological accuracy; Altaf A supported the literature review and data validation and contributed to the writing and editing of the methods section; Ahmed N assisted in developing the study methodology and provided expert input into the interpretation of the results; Siyal M contributed to the study coordination, managed references, and participated in critical review and editing of the final draft; Kakar F provided substantial input in study conception and offered expert advice on pediatric gastroenterology-related content; Qureshi S supported the ethical approval processing, ensured adherence to clinical reporting guidelines, and participated in the review of patient-related data; Niaz SK supervised the overall project, provided critical intellectual content throughout the study, and gave final approval of the manuscript prior to submission; all authors read and approved the final version of the manuscript.
Institutional review board statement: This study was approved by the local Ethics Committee (No. ERC/SIAG/Approval/2025/03).
Informed consent statement: This retrospective study was conducted using anonymized data obtained from the medical records of patients who underwent endoscopic ultrasound-guided pancreatic pseudocyst drainage between 2015 and 2024. Due to the retrospective nature of the study, formal informed consent from individual patients or their guardians was not required. However, all patient data were handled with strict confidentiality, and no identifiable information was disclosed. Institutional approval was obtained prior to data collection in accordance with ethical standards and local regulations.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The data that support the findings of this study are available from the corresponding author upon reasonable request. However, access to the data is subject to institutional policies and ethical considerations to protect patient confidentiality. All shared data will be de-identified to ensure compliance with privacy regulations.
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: Shanil Kadir, Assistant Professor, Consultant, FRCP, Gastroenterology, Sindh Institute of Advanced Endoscopy and Gastroenterology, Heritage Building, Dr Ruth K.M. Pfau Civil Hospital, Mission Road, Karachi 75000, Sindh, Pakistan. shanildr@yahoo.com
Received: July 17, 2025
Revised: August 28, 2025
Accepted: January 7, 2026
Published online: March 5, 2026
Processing time: 209 Days and 19.5 Hours
Abstract
BACKGROUND

Pancreatic pseudocyst (PPC) is a well-encapsulated peri-pancreatic fluid collection that occurs at least 4 weeks after acute pancreatitis. The prevalence of PPC is 8%-41% among patients with a history of pancreatitis. Management includes conventional surgery and percutaneous radiological or endoscopic approaches. Endoscopic ultrasound (EUS)-guided drainage of PPC appears to be a safe and less invasive treatment option. Its efficacy is well established in the adult population. However, data regarding its usage in the pediatric population are limited.

AIM

To determine the safety and efficacy of EUS-guided PPC drainage in children over 10 years.

METHODS

A retrospective review was conducted of pediatric patients (aged < 18 years) who were referred for EUS-guided PPC drainage between 2015 and 2024. Twenty-eight patients were identified who had been referred to our department for EUS-guided PPC drainage, including 21 patients with symptoms who underwent the procedure. Effectiveness was assessed based on technical success and clinical resolution of symptoms.

RESULTS

The mean age was 13.81 ± 3.25 years (range: 6-18 years) with 52.4% males. The locations of the PPCs were distributed along the pancreatic body (38.1%) and head/neck regions (38.1%). EUS-guided drainage was performed under general anesthesia. Complete aspiration without stent placement was performed in 11 patients (52.4%) with an average PPC size of 4.3 cm × 3.9 cm. Two double-pigtail plastic stents were required in 9 patients (47.6%) with a mean size of 8.4 cm × 8.0 cm. Lumen-apposing metal stents were required in 1 patient. Technical and clinical successes were achieved in all cases. One patient (4.8%) experienced recurrence that required repeat drainage. No major complications were observed.

CONCLUSION

EUS-guided PPC drainage was a safe and effective procedure for our pediatric population and should be preferred over conventional techniques, performed by experienced endoscopists under general anesthesia by pediatric anesthetists.

Keywords: Pancreatic pseudocyst; Endoscopic ultrasound; Endoscopic ultrasound-guided drainage; Pediatric endoscopy; Drainage techniques; Double pigtail plastic stent; Lumen-apposing metal stents

Core Tip: Pancreatic pseudocysts are uncommon in children. However, they are clinically significant complications of pancreatitis. This 10-year retrospective review evaluated the safety and efficacy of endoscopic ultrasound-guided drainage of pancreatic pseudocysts in a pediatric population. The study demonstrated 100% technical and clinical success with minimal complications. Endoscopic ultrasound-guided drainage is a safe and effective first-line approach in children, particularly when performed under general anesthesia by an experienced endoscopist.