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Review
. 2013 Sep;46(5):506-14.
doi: 10.5946/ce.2013.46.5.506. Epub 2013 Sep 30.

Pancreatic fluid collection drainage by endoscopic ultrasound: an update

Shashideep Singhal  1 , Stephen R Rotman, Monica Gaidhane, Michel Kahaleh
Affiliations
Review

Pancreatic fluid collection drainage by endoscopic ultrasound: an update

Shashideep Singhal et al. Clin Endosc. 2013 Sep.

Abstract

Endoscopic management of symptomatic pancreatic fluid collections (PFCs) is now considered to be first line therapy. Expanded use of endoscopic ultrasound (EUS) techniques has resulted in increased applicability, safety, and efficacy of endoscopic transluminal PFC drainage. Steps include EUS-guided trangastric or transduodenal fistula creation into the PFC followed by stent placement or nasocystic drain deployment in order to decompress the collection. With the remarkable improvement in the available accessories and stents and development of exchange free access device; EUS drainage techniques have become simpler and less time consuming. The use of self-expandable metal stents with modifications to drain PFC has helped in overcoming some previously encountered challenges. PFCs considered suitable for endoscopic drainage include collection present for greater than 4 weeks, possessing a well-formed wall, position accessible endoscopically and located within 1 cm of the duodenal or gastric walls. Indications for EUS-guided drainage have been increasing which include unusual location of the collection, small window of entry, nonbulging collections, coagulopathy, intervening varices, failed conventional transmural drainage, indeterminate adherence of PFC to the luminal wall or suspicion of malignancy. In this article, we present a review of literature to date and discuss the recent developments in EUS-guided PFC drainage.

Keywords: Endosonography; Nonbulging pancreatic fluid collections; Pancreatic fluid collections; Pancreatic pseudocyst.

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Conflict of interest statement

Dr. Michel Kahaleh has received grant support from Boston Scientific, Fujinon, EMcison, Xlumena Inc., MaunaKea, and MI Tech. He is a consultant for Xlumena Inc.

Figures

Fig. 1
Fig. 1
Endoscopic ultrasound view of the needle puncture.
Fig. 2
Fig. 2
Fluoroscopic view of guidewire placed through the stomach wall.
Fig. 3
Fig. 3
Fluoroscopic view of guidewire within the pancreatic fluid collection.
Fig. 4
Fig. 4
Fluoroscopic view of balloon dilation of the tract.
Fig. 5
Fig. 5
Endoscopic view of balloon dilation of the tract.
Fig. 6
Fig. 6
Endoscopic view of deployed metal stent.
Fig. 7
Fig. 7
Fluoroscopic view of the pigtails placed within the metal stent.
See this image and copyright information in PMC

References

    1. Baron TH, Thaggard WG, Morgan DE, Stanley RJ. Endoscopic therapy for organized pancreatic necrosis. Gastroenterology. 1996;111:755–764. - PubMed
    1. Baillie J. Pancreatic pseudocysts (Part I) Gastrointest Endosc. 2004;59:873–879. - PubMed
    1. Yeo CJ, Cameron JL, Sohn TA, et al. Six hundred fifty consecutive pancreaticoduodenectomies in the 1990s: pathology, complications, and outcomes. Ann Surg. 1997;226:248–257. - PMC - PubMed
    1. Arvanitakis M, Delhaye M, Chamlou R, et al. Endoscopic therapy for main pancreatic-duct rupture after Silastic-ring vertical gastroplasty. Gastrointest Endosc. 2005;62:143–151. - PubMed
    1. Klöppel G. Pseudocysts and other non-neoplastic cysts of the pancreas. Semin Diagn Pathol. 2000;17:7–15. - PubMed

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