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Alali A, Mosko J, May G, et al. Endoscopic Ultrasound-Guided Management of Pancreatic Fluid Collections: Update and Review of the Literature. Clin Endosc. 2017;50(2):117-125doi: 10.5946/ce.2017.045.
Alali, A., Mosko, J., May, G., & Teshima, C. (2017). Endoscopic Ultrasound-Guided Management of Pancreatic Fluid Collections: Update and Review of the Literature. Clinical endoscopy, 50(2), 117-125. https://doi.org/10.5946/ce.2017.045
Alali, Ali, et al. "Endoscopic Ultrasound-Guided Management of Pancreatic Fluid Collections: Update and Review of the Literature." Clinical endoscopy vol. 50,2 (2017): 117-125. doi: https://doi.org/10.5946/ce.2017.045
Alali A, Mosko J, May G, Teshima C. Endoscopic Ultrasound-Guided Management of Pancreatic Fluid Collections: Update and Review of the Literature. Clin Endosc. 2017 Mar;50(2):117-125. doi: 10.5946/ce.2017.045. Epub 2017 Mar 30. PMID: 28391671; PMCID: PMC5398360.
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Clin Endosc. 2017 Mar;50(2):117-125. doi: 10.5946/ce.2017.045. Epub 2017 Mar 30.

Endoscopic Ultrasound-Guided Management of Pancreatic Fluid Collections: Update and Review of the Literature.

Clinical endoscopy

Ali Alali, Jeffrey Mosko, Gary May, Christopher Teshima

Affiliations

  1. The Center for Therapeutic Endoscopy and Endoscopic Oncology, St. Michael's Hospital, University of Toronto, ON, Canada.

PMID: 28391671 PMCID: PMC5398360 DOI: 10.5946/ce.2017.045

Abstract

Severe acute pancreatitis is often complicated by the development of pancreatic fluid collections (PFCs), which may be associated with significant morbidity and mortality. It is crucial to accurately classify these collections as a pseudocyst or walled-off necrosis (WON) given significant differences in outcomes and management. Interventions for PFCs have increasingly shifted to less invasive strategies, with endoscopic ultrasound (EUS)-guided methods being shown to be safer and equally effective as more invasive surgical techniques. In recent years, many new developments have improved the safety and efficacy of EUS-guided interventions, such as the introduction of lumen-apposing metal stents (LAMS), direct endoscopic necrosectomy (DEN) and multiple other adjunctive techniques. Despite these developments, treatment of PFCs, and infected WON in particular, continues to be associated with significant morbidity and mortality. In this article, we discuss the EUS-guided management of PFCs while reviewing the latest developments and controversies in the field. We end by summarizing our own approach to managing PFCs.

Keywords: Endosonography; Pancreatic fluid collection; Pseudocyst; Walled-off necrosis

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