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. 2024 Jul-Aug;13(4):205-217.
doi: 10.1097/eus.0000000000000080. Epub 2024 Aug 21.

Consensus guidelines on the diagnosis and treatment of pancreatic pseudocyst and walled-off necrosis from a Chinese multiple disciplinary team expert panel

Huiyun Zhu  1 , Yiqi Du  1 , Kaixuan Wang  1 , Zhaoshen Li  1 , Zhendong Jin  1
Affiliations

Consensus guidelines on the diagnosis and treatment of pancreatic pseudocyst and walled-off necrosis from a Chinese multiple disciplinary team expert panel

Huiyun Zhu et al. Endosc Ultrasound. 2024 Jul-Aug.

Abstract

Objective: To prepare a set of practice guidelines to standardize the entire process, from diagnosis to treatment and follow-up, for pancreatic pseudocysts and walled-off necrosis.

Methods: Thirty-six experts in the fields of digestive endoscopy, pancreatic surgery, interventional radiology, and others presented their opinions via discussions in online conferences by referring to the patient, intervention, comparison, and outcomes principles and then reviewed the evidence and statements using the Delphi method to reach a consensus. The consensus of >80% was finally achieved for the items.

Results: The experts discussed and reached a consensus on 29 statements including 10 categories: (1) definition and classification, (2) imaging and endoscopic diagnosis, (3) therapeutic implications, (4) surgical therapy, (5) percutaneous catheter drainage, (6) endoscopic retrograde cholangiopancreatography, (7) EUS-guided drainage, (8) stent selection for EUS-guided drainage, (9) complication related to stents for cyst drainage, and (10) drug treatment and follow-up.

Conclusion: This consensus based on the clinical experience of experts in various fields and international evidence-based medicine further standardizes the multidisciplinary diagnosis and treatment processes for pancreatic pseudocysts and walled-off necrosis.

Keywords: Consensus; Diagnosis and treatment; Pancreatic pseudocyst; Walled-off necrosis.

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Conflict of interest statement

Zhaoshen Li is an Honorary Editor-in-Chief of the journal, and Zhendong Jin is an Associate Editor-in-Chief. The article was subjected to the standard procedures of the journal, with a review process independent of the editors and their research group.

Figures

Figure 1
Figure 1
CT, MRI, and EUS images of typical PPC (A–C) and WON (D–F). CT: computed tomography; MRI, magnetic resonance imaging; PPC, pancreatic pseudocyst; WON: walled-off pancreatic necrosis.
Figure 2
Figure 2
Schematic illustration of dual chamber-fixed metal support (LAMS). LAMS: lumen-apposing metal stent.
Figure 3
Figure 3
A flow diagram illustrating the treatment procedures for pancreatic pseudocyst and walled-off necrosis. PPC: pancreatic pseudocysts; WON: walled-off pancreatic necrosis; PCD: percutaneous catheter drainage.
See this image and copyright information in PMC

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