Endoscopic cystogastrostomy in children (clinical series)

Objective: To evaluate the feasibility and outcomes of endoscopic cystogastrostomy in pediatric patients. Materials and Methods. Between 2021 and 2023, endoscopic interventions for pancreatic cysts were performed on five pediatric patients (four boys and one girl), aged 10 to 11 years (mean age 10.6 years). The etiology of the cysts was mixed (dietary and drug-related) in two patients, pancreatic trauma in one, and idiopathic pancreatitis in two. Additional imaging (abdominal MRI and endoscopic ultrasound) revealed cyst sizes ranging from 6 to 10 cm (mean size 8 cm). Results. No complications occurred during the interventions. The average procedure time ranged from 110 to 125 minutes (mean 115.7 minutes). To ensure drainage, double pigtail stents were placed (two stents in four patients, one stent in one patient). No postoperative complications were observed, although one patient required a 7-day course of antibiotics. At follow-up, all patients were evaluated at least 6 months post-surgery, with no reported complaints. MRI scans confirmed complete resolution of the cysts. Stents were removed no earlier than 6 months post-procedure. Conclusions. Endoscopic cystogastrostomy, performed under ultrasound guidance for pancreatic complications in pediatric patients, is a highly effective, minimally invasive alternative to traditional surgery. However, further multicenter studies are necessary to evaluate long-term outcomes and the broader potential of this technique.