Endoscopic management of walled-off pancreatic fluid collections: Techniques
- Douglas A Howell, MD, FASGE, FACG
Douglas A Howell, MD, FASGE, FACG
- Section Editor — EUS/ERCP
- Assistant Clinical Professor of Medicine, Tufts Medical School Director,
- Pancreaticobiliary Center Director, Advanced Interventional Endoscopy Fellowship, Maine Medical Center
- Raj J Shah, MD, FASGE, AGAF
Raj J Shah, MD, FASGE, AGAF
- Professor of Medicine, University of Colorado School of Medicine
- Director, Pancreaticobiliary Endoscopy
- Digestive Health Center, University of Colorado Hospital, Anschutz Medical Campus
Walled-off pancreatic fluid collections are most often the result of acute pancreatitis. They may also be seen in patients with chronic pancreatitis and in patients who have suffered blunt or penetrating pancreatic trauma. Endoscopic drainage of walled-off pancreatic fluid collections is an accepted alternative to surgery when intervention is necessary.
This topic will review the endoscopic techniques used in the management of walled-off pancreatic fluid collections. The classification of pancreatic cysts, the diagnosis of walled-off pancreatic fluid collections, and the efficacy and complications of endoscopic, percutaneous, and surgical approaches used to manage these collections are discussed separately.To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- CHOICE OF DRAINAGE PROCEDURE
- Transmural versus transpapillary approach
- PATIENT PREPARATION
- ENDOSCOPY-GUIDED TRANSMURAL DRAINAGE
- Identifying a puncture site using EUS
- Puncturing the walled-off pancreatic collection
- EUS-guided stent placement and drainage
- - Plastic versus self-expandable metal stents
- Combining drainage procedures
- MANAGING PANCREATIC NECROSIS
- Endoscopy-guided techniques
- Less common techniques
- TRANSPAPILLARY STENTING AND DRAINAGE
- BILIARY OBSTRUCTION
- POST-DRAINAGE MANAGEMENT
- Post-procedure instructions
- Imaging and stent removal
- Nonresolving fluid collections
- SUMMARY AND RECOMMENDATIONS