배경/목적: 췌장 가성 낭종은 급성과 만성 췌장염의 흔한 합병증이다. 내시경 초음파를 통한 배액술은 여러단계와 여러장비들이 필요하다. 모든 병원에서 선형초음파내시경 기계 및 투시영상 검사실을 같이 갖추진 못하고 있다. 우리는 투시영상없이 초음파내시경을 통한 췌장가성낭종의 배액술의 안전성과 효율성을 확인하고자 한다. 방법: 2009년 1월부터 2016년 12월까지 초음파내시경을 통해서 가성낭종의 배액술을 시행한 10명의 환자를 분석하였다. 경위적 접근법을 통하여 시행하였으며, 1개 혹은 2개 의 7Fr 이중돼지꼬리 플라스틱 배액관을 사용하여 배액술을 시행하였다. 결과: 기술적 성공률은 100% 이며, 임상적 성공률은 80% 였다. 2명의 환자에서는 내시경적 배액술로성공하지 못하여, 경피부배액술을 시행하였고, 수술적치료 없이 호전되었다. 3명의 환자에서는 합병증이 발생하였다(출혈, 감염, 스텐트 이탈). 평균 36.5개월을 추적관찰하였을때 가성낭종이 재발한 환자는 없었다. 결론: 투시영상없이 초음파내시경을 통한 췌장 가성낭종의 배액술은 췌장가성낭종의 치료에서 안전하고, 기술적으로 가능하며, 효과적인 방법이다.

Background/Aims: Pancreatic pseudocyst is a common complication of acute and chronic pancreatitis. Endoscopy ultrasound (EUS)-guided drainage includes multiple steps and requires many resources such as a linear echoendoscope and a fluoroscopy room, which may not be available at all medical centers. We aimed to evaluate the efficacy and safety of EUS-guided pancreatic pseudocyst drainage without fluoroscopy. Methods: This retrospective study analyzed 10 patients who had undergone EUSguided transmural drainage of pancreatic pseudocyst without use of fluoroscopy at the Pusan National University Hospital between January 2009 and December 2016. Drainage was performed via a transgastric approach and one or two 7 Fr double-pigtail stents were inserted. Results: The technical success rate was 100% and the clinical success rate was 80%. In two patients, clinical success was not achieved and additional percutaneous catheter drainage was done. Therefore, pseudocysts in all the patients were treated successfully without surgical drainage. However, there were three adverse events in three patients: bleeding, infection, and stent migration in each respective patient. During the median follow-up period of 36.5 months, there was no recurrence of pseudocysts in any of the patients. Conclusions: EUS-guided transmural drainage of pseudocyst drainage without use of fluoroscopy is a technically feasible, safe, and effective procedure for the treatment of pancreatic pseudocyst.

INTRODUCTION
 METHODS
 RESULTS
 DISCUSSION
 요 약
 Acknowledgments
 REFERENCES

• 이문원(부산대학교 의학전문대학원 내과학교실, 부산대학교병원 의생명연구원, Department of Internal Medicine, Pusan National University School of Medicine, and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea) | Moon Won Lee
• 송병구(부산대학교 의학전문대학원 내과학교실, 부산대학교병원 의생명연구원, Department of Internal Medicine, Pusan National University School of Medicine, and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea) | Byeong Gu Song
• 백동훈(부산대학교 의학전문대학원 내과학교실, 부산대학교병원 의생명연구원, Department of Internal Medicine, Pusan National University School of Medicine, and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea) | Dong Hoon Baek
• 김동욱(부산대학교 의학전문대학원 내과학교실, 부산대학교병원 의생명연구원, Department of Internal Medicine, Pusan National University School of Medicine, and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea) | Dong Uk Kim
• 송근암(부산대학교 의학전문대학원 내과학교실, 부산대학교병원 의생명연구원, Department of Internal Medicine, Pusan National University School of Medicine, and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea) | Geun Am Song
• 편성익(부산대학교 의학전문대학원 내과학교실, 부산대학교병원 의생명연구원, Department of Internal Medicine, Pusan National University School of Medicine, and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea) | Sung Ik Pyeon
• 김광하(부산대학교 의학전문대학원 내과학교실, 부산대학교병원 의생명연구원, Department of Internal Medicine, Pusan National University School of Medicine, and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea) | Gwang Ha Kim Corresponding author
• 한성용(부산대학교 의학전문대학원 내과학교실, 부산대학교병원 의생명연구원, Department of Internal Medicine, Pusan National University School of Medicine, and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea) | Sung Yong Han