Interventional Radiology-Assisted Endoscopic Transmural Drainage of Pancreatic Fluid Collections – An Image-Guided Alternative to EUS-Drainage.

2017 ◽  
Author(s):  
Jeffrey Hawel
Keyword(s):  
Interventional Radiology ◽  
Pancreatic Fluid Collections ◽  
Image Guided ◽  
Pancreatic Fluid ◽  
Transmural Drainage ◽  
Fluid Collections

scholarly journals Endoscopic Management of Pancreatic Fluid Collections

2021 ◽  
Vol 10 (2) ◽  
pp. 284
Author(s):  
Robert Dorrell ◽  
Swati Pawa ◽  
Rishi Pawa
Keyword(s):  
Patient Outcomes ◽  
Endoscopic Management ◽  
Metal Stents ◽  
Ultrasound Guided ◽  
Endoscopic Intervention ◽  
Endoscopic Necrosectomy ◽  
Pancreatic Fluid Collections ◽  
Pancreatic Fluid ◽  
Transmural Drainage ◽  
Fluid Collections

Pancreatic fluid collections (PFCs) are a common sequela of pancreatitis. Most PFCs can be managed conservatively, but symptomatic PFCs require either surgical, percutaneous, or endoscopic intervention. Recent advances in the therapeutics of PFCs, including the step-up approach, endoscopic ultrasound-guided transmural drainage with lumen apposing metal stents, and direct endoscopic necrosectomy, have ushered endoscopy to the forefront of PFCs management and have allowed for improved patient outcomes and decreased morbidity. In this review, we explore the progress and future of endoscopic management of PFCs.

Management of Pancreatic Fluid Collections: A Changing of the Guard from Surgery to Endoscopy

2011 ◽  
Vol 77 (12) ◽  
pp. 1650-1655 ◽  
Author(s):  
Shyam Varadarajulu ◽  
C. Mel Wilcox ◽  
Sahibzada Latif ◽  
Milind Phadnis ◽  
John D. Christein
Keyword(s):  
Practice Patterns ◽  
Treated Group ◽  
Pancreatic Fluid Collections ◽  
Pancreatic Fluid ◽  
Group I ◽  
Impacting Factors ◽  
Transmural Drainage ◽  
Group Ii ◽  
Fluid Collections

The aim of this study was to assess for any trend in management of pancreatic fluid collections (PFCs) and identify impacting factors. The endoscopy and surgical databases were queried for PFC patients. PFCs were categorized as pseudocysts (PP) or complex collections (CC) that included abscess/necrosis. The outcome measures were to compare the utilization of surgery and endoscopy from 2004 to 2007 (group I) and from 2008 to 2010 (group II) and identify factors impacting practice patterns. A total of 285 patients were treated: group I included 119 and group II 166. Of 119 group I patients, 29 per cent were treated by surgery and 71 per cent by endoscopy. Of 85 endoscopy patients, 42 per cent were drained by conventional transmural drainage and 58 per cent by endoscopic ultrasound (EUS). Of 166 group II patients, 31 per cent were treated surgically and 69 per cent endoscopically. Of the 115 endoscopy patients, 17 per cent were drained by conventional transmural drainage and 83 per cent by EUS. Compared with group I, all pseudocysts in group II were treated by endoscopy (84% vs 100%, P = 0.001). There was no difference in the rate of CC treated by endoscopy between both groups (57.7% vs 56.8%, P = 0.9). PFCs not causing luminal compression ( P < 0.0001) or measuring <9 cm in size ( P < 0.0001) were more likely to require EUS. There was a significant trend at our institution in the management of PFCs with all pseudocysts presently being treated only by endoscopy. The ability of EUS to access smaller size PFCs and those not causing luminal compression has significantly expanded the role of endoscopy in PFC management.

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