Materials and methods

A descriptive retrospective study was conducted, including 35 patients with peripancreatic collections as a complication of acute pancreatitis who underwent EUS-guided drainage between January 2023 and March 2026 at the Hospital Regional de Alta Especialidad Bicentenario de la Independencia, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), located in Tultitlán, State of Mexico, Mexico.

Patients with local complications persisting for more than four weeks and ongoing symptoms were included. These were defined as pancreatic pseudocysts and WON, with or without evidence of infection.

Case identification was performed through review of the institutional Endoscopy Unit database, using diagnostic codes related to peripancreatic collections and EUS-guided drainage procedures. EUS-guided drainage was performed by experienced endoscopists using a linear-array echoendoscope. The target collection was identified and evaluated regarding size, contents, wall maturity, and proximity to adjacent structures. After an optimal access point was identified, the collection was punctured under EUS guidance using a 19-gauge needle. The transmural tract was subsequently dilated using a balloon dilator, according to the characteristics of the collection and the endoscopist’s preference.

Variables analyzed included age, sex, and type of pancreatic collection, classified as pancreatic pseudocyst or WON, with or without infection. Technical success was defined as complete resolution of the cavity and associated symptoms after the initial intervention. Recurrence was defined as the reappearance of the collection associated with clinical symptoms more than four weeks after stent removal.

The type of stent used was recorded, classified as a double pigtail plastic stent or a LAMS. Stent indwelling time (in days) and post-procedural hospital stay were also analyzed.

The transmural drainage route (gastric or duodenal) was documented, as well as procedure-related complications, including stent obstruction or migration, bleeding, and perforation. Technical failure was defined as the inability to perform a puncture due to the unfavorable anatomical location of the collection. Thirty-day mortality was also recorded.

Patients with cystic neoplasms misclassified as pancreatic collections, those without post-procedural follow-up, and those with incomplete medical records were excluded.

The statistical analysis was descriptive, so categorical variables were reported as percentages; non-normally distributed variables were described using medians and interquartile ranges, and normally distributed variables were described using mean and standard deviation (SD).

The study protocol was reviewed and approved by the Research and Ethics Committee of the Hospital Regional de Alta Especialidad Bicentenario de la Independencia, ISSSTE. A literature review on peripancreatic collections and their endoscopic management was conducted using national and international databases. Based on available evidence and review by specialists in general surgery, gastrointestinal endoscopy, and endoscopic ultrasound, the study conclusions were formulated.