Endoscopic Management of Pancreatic Fluid Collections-revisited

Overview

Journal World J Gastroenterol

Publisher Baishideng Publishing Group

Specialty Gastroenterology

Date 2017 May 11

PMID 28487603

Citations 14

Authors

Zaheer Nabi

Jahangeer Basha

D Nageshwar Reddy

Affiliations

Soon will be listed here.

Abstract

The development of pancreatic fluid collections (PFC) is one of the most common complications of acute severe pancreatitis. Most of the acute pancreatic fluid collections resolve and do not require endoscopic drainage. However, a substantial proportion of acute necrotic collections get walled off and may require drainage. Endoscopic drainage of PFC is now the preferred mode of drainage due to reduced morbidity and mortality as compared to surgical or percutaneous drainage. With the introduction of new metal stents, the efficiency of endoscopic drainage has improved and the task of direct endoscopic necrosectomy has become easier. The requirement of re-intervention is less with new metal stents as compared to plastic stents. However, endoscopic drainage is not free of adverse events. Severe complications including bleeding, perforation, sepsis and embolism have been described with endoscopic approach to PFC. Therefore, the endoscopic management of PFC is a multidisciplinary affair and involves interventional radiologists as well as GI surgeons to deal with unplanned adverse events and failures. In this review we discuss the recent advances and controversies in the endoscopic management of PFC.

Citing Articles

From Scalpel to Scope: How Surgical Techniques Made Way for State-of-The-Art Endoscopic Procedures.

Bahdi F, Labora A, Shah S, Farooq M, Wangrattanapranee P, Donahue T Gastro Hep Adv. 2024; 3(3):370-384.

PMID: 39131137 PMC: 11307641. DOI: 10.1016/j.gastha.2023.10.013.

Single Center Experience of Eus-Guided Cystogastrostomy and Lumen-Apposing Metal Stent (LAMS) Positioning in Children with Pancreatic Fluid Collections: A Case Series.

Pasqualetto A, Boroni G, Moneghini D, Parolini F, Orizio P, Bulotta A Children (Basel). 2024; 11(6).

PMID: 38929223 PMC: 11202220. DOI: 10.3390/children11060643.

Drainage of pancreatic fluid collections in acute pancreatitis: A comprehensive overview.

Bansal A, Gupta P, Singh A, Shah J, Samanta J, Mandavdhare H World J Clin Cases. 2022; 10(20):6769-6783.

PMID: 36051118 PMC: 9297419. DOI: 10.12998/wjcc.v10.i20.6769.

Outcomes of Endoscopic Drainage in Children with Pancreatic Fluid Collections: A Systematic Review and Meta-Analysis.

Nabi Z, Talukdar R, Lakhtakia S, Reddy D Pediatr Gastroenterol Hepatol Nutr. 2022; 25(3):251-262.

PMID: 35611379 PMC: 9110851. DOI: 10.5223/pghn.2022.25.3.251.

Endoscopic Management of Large Peripancreatic Fluid Collections in Two Pediatric Patients by Endoscopic Ultrasound-guided Transmural Drainage.

Walsh L, Groff A, Mathew A, Moyer M Pediatr Gastroenterol Hepatol Nutr. 2020; 23(1):105-109.

PMID: 31988881 PMC: 6966221. DOI: 10.5223/pghn.2020.23.1.105.

References

Varadarajulu S, Wilcox C . Endoscopic placement of permanent indwelling transmural stents in disconnected pancreatic duct syndrome: does benefit outweigh the risks?. Gastrointest Endosc. 2011; 74(6):1408-12. DOI: 10.1016/j.gie.2011.07.049. View

Holt B, Varadarajulu S . The endoscopic management of pancreatic pseudocysts (with videos). Gastrointest Endosc. 2015; 81(4):804-12. DOI: 10.1016/j.gie.2014.12.026. View

Gardner T, Chahal P, Papachristou G, Vege S, Petersen B, Gostout C . A comparison of direct endoscopic necrosectomy with transmural endoscopic drainage for the treatment of walled-off pancreatic necrosis. Gastrointest Endosc. 2009; 69(6):1085-94. DOI: 10.1016/j.gie.2008.06.061. View

Guenther L, Hardt P, Collet P . Review of current therapy of pancreatic pseudocysts. Z Gastroenterol. 2015; 53(2):125-35. DOI: 10.1055/s-0034-1385713. View

Chandran S, Efthymiou M, Kaffes A, Chen J, Kwan V, Murray M . Management of pancreatic collections with a novel endoscopically placed fully covered self-expandable metal stent: a national experience (with videos). Gastrointest Endosc. 2014; 81(1):127-35. DOI: 10.1016/j.gie.2014.06.025. View

Akshintala V, Saxena P, Zaheer A, Rana U, Hutfless S, Lennon A . A comparative evaluation of outcomes of endoscopic versus percutaneous drainage for symptomatic pancreatic pseudocysts. Gastrointest Endosc. 2013; 79(6):921-8. DOI: 10.1016/j.gie.2013.10.032. View

Bapaye A, Itoi T, Kongkam P, Dubale N, Mukai S . New fully covered large-bore wide-flare removable metal stent for drainage of pancreatic fluid collections: results of a multicenter study. Dig Endosc. 2014; 27(4):499-504. DOI: 10.1111/den.12421. View

Varadarajulu S, Lopes T, Wilcox C, Drelichman E, Kilgore M, Christein J . EUS versus surgical cyst-gastrostomy for management of pancreatic pseudocysts. Gastrointest Endosc. 2008; 68(4):649-55. DOI: 10.1016/j.gie.2008.02.057. View

Attam R, Trikudanathan G, Arain M, Nemoto Y, Glessing B, Mallery S . Endoscopic transluminal drainage and necrosectomy by using a novel, through-the-scope, fully covered, large-bore esophageal metal stent: preliminary experience in 10 patients. Gastrointest Endosc. 2014; 80(2):312-8. DOI: 10.1016/j.gie.2014.02.013. View

10.

Trevino J, Tevino J, Tamhane A, Varadarajulu S . Successful stenting in ductal disruption favorably impacts treatment outcomes in patients undergoing transmural drainage of peripancreatic fluid collections. J Gastroenterol Hepatol. 2010; 25(3):526-31. DOI: 10.1111/j.1440-1746.2009.06109.x. View

11.

Tellez-Avina F, Casasola-Sanchez L, Ramirez-Luna M, Saul A, Murcio-Perez E, Chan C . Permanent Indwelling Transmural Stents for Endoscopic Treatment of Patients With Disconnected Pancreatic Duct Syndrome: Long-term Results. J Clin Gastroenterol. 2016; 52(1):85-90. DOI: 10.1097/MCG.0000000000000754. View

12.

Siddiqui A, Kowalski T, Loren D, Khalid A, Soomro A, Mazhar S . Fully covered self-expanding metal stents versus lumen-apposing fully covered self-expanding metal stent versus plastic stents for endoscopic drainage of pancreatic walled-off necrosis: clinical outcomes and success. Gastrointest Endosc. 2016; 85(4):758-765. DOI: 10.1016/j.gie.2016.08.014. View

13.

Bang J, Varadarajulu S . Transmural drainage versus transpapillary stenting and transmural drainage: not an open and shut case…yet. Gastrointest Endosc. 2016; 83(5):1046. DOI: 10.1016/j.gie.2015.12.012. View

14.

Shah R, Shah J, Waxman I, Kowalski T, Sanchez-Yague A, Nieto J . Safety and efficacy of endoscopic ultrasound-guided drainage of pancreatic fluid collections with lumen-apposing covered self-expanding metal stents. Clin Gastroenterol Hepatol. 2014; 13(4):747-52. DOI: 10.1016/j.cgh.2014.09.047. View

15.

Panamonta N, Ngamruengphong S, Kijsirichareanchai K, Nugent K, Rakvit A . Endoscopic ultrasound-guided versus conventional transmural techniques have comparable treatment outcomes in draining pancreatic pseudocysts. Eur J Gastroenterol Hepatol. 2012; 24(12):1355-62. DOI: 10.1097/MEG.0b013e32835871eb. View

16.

Sharaiha R, Tyberg A, Khashab M, Kumta N, Karia K, Nieto J . Endoscopic Therapy With Lumen-apposing Metal Stents Is Safe and Effective for Patients With Pancreatic Walled-off Necrosis. Clin Gastroenterol Hepatol. 2016; 14(12):1797-1803. DOI: 10.1016/j.cgh.2016.05.011. View

17.

Varadarajulu S, Bang J, Sutton B, Trevino J, Christein J, Wilcox C . Equal efficacy of endoscopic and surgical cystogastrostomy for pancreatic pseudocyst drainage in a randomized trial. Gastroenterology. 2013; 145(3):583-90.e1. DOI: 10.1053/j.gastro.2013.05.046. View

18.

Hookey L, Debroux S, Delhaye M, Arvanitakis M, Le Moine O, Deviere J . Endoscopic drainage of pancreatic-fluid collections in 116 patients: a comparison of etiologies, drainage techniques, and outcomes. Gastrointest Endosc. 2006; 63(4):635-43. DOI: 10.1016/j.gie.2005.06.028. View

19.

Dhir V, Teoh A, Bapat M, Bhandari S, Joshi N, Maydeo A . EUS-guided pseudocyst drainage: prospective evaluation of early removal of fully covered self-expandable metal stents with pancreatic ductal stenting in selected patients. Gastrointest Endosc. 2015; 82(4):650-7. DOI: 10.1016/j.gie.2015.01.061. View

20.

Sharaiha R, Defilippis E, Kedia P, Gaidhane M, Boumitri C, Lim H . Metal versus plastic for pancreatic pseudocyst drainage: clinical outcomes and success. Gastrointest Endosc. 2015; 82(5):822-7. DOI: 10.1016/j.gie.2015.02.035. View