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Review
. 2015 Jul;6(3):199-207.
doi: 10.1136/flgastro-2014-100444. Epub 2014 Jun 26.

Endoscopic management of peripancreatic fluid collections

Jatinder Goyal  1 , Jayapal Ramesh  2
Affiliations
Review

Endoscopic management of peripancreatic fluid collections

Jatinder Goyal et al. Frontline Gastroenterol. 2015 Jul.

Abstract

Peripancreatic fluid collections are a well-known complication of pancreatitis and can vary from fluid-filled collections to entirely necrotic collections. Although most of the fluid-filled pseudocysts tend to resolve spontaneously with conservative management, intervention is necessary in symptomatic patients. Open surgery has been the traditional treatment modality of choice though endoscopic, laparoscopic and transcutaneous techniques offer alternative drainage approaches. During the last decade, improvement in endoscopic ultrasound technology has enabled real-time access and drainage of fluid collections that were previously not amenable to blind transmural drainage. This has initiated a trend towards use of this modality for treatment of pseudocysts. In this review, we have summarised the existing evidence for endoscopic drainage of peripancreatic fluid collections from published studies.

Keywords: ENDOSCOPIC ULTRASONOGRAPHY; PANCREATIC PSEUDOCYST.

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Figures

Figure 1
Figure 1
Suggested clinical algorithm for the management of peripancreatic fluid collections ERP, endoscopic retrograde pancreatography; EUS, endoscopic ultrasound; PFC, peripancreatic fluid collection. *Choose the option based on availability and local expertise. #Consider referral to a tertiary centre with therapeutic EUS expertise.
Figure 2
Figure 2
Approach to endoscopic ultrasound (EUS)-guided pseudocyst drainage. (A) Fluoroscopy image of guidewire coiled in the pseudocyst cavity; (B) fluoroscopy image of balloon dilation of cyst gastrostomy tract demonstrating the waist; (C) fluoroscopy image showing obliteration of balloon waist representing fistula creation; (D) fluoroscopy image of transmural stents being deployed over the guidewire.
See this image and copyright information in PMC

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