Ahmed Akhter MD , Mark E. Benson MD , Deepak V. Gopal MD, FRCP(C), FACP, AGAF, FASGE, FACG
{"title":"Endosonographic drainage of pancreatic fluid collections and walled-off necrosis","authors":"Ahmed Akhter MD , Mark E. Benson MD , Deepak V. Gopal MD, FRCP(C), FACP, AGAF, FASGE, FACG","doi":"10.1016/j.tgie.2017.11.002","DOIUrl":null,"url":null,"abstract":"<div><p><span>Endosonographic drainage of pseudocysts<span><span> and walled-off necrosis (WON) has not been standardized. Drainage of pseudocysts via endosonographic guidance has high rates of technical success via the transmural approach. Alternative modalities including transpapillary endoscopic retrograde pancreatography with </span>pancreatic duct<span> sphincterotomy and pancreatic duct </span></span></span>stent placement are options for patients with small pseudocysts and in the presence of pancreatic duct disruption. Drainage of WON has a variety of approaches and may require a combination of endoscopic or percutaneous techniques to achieve the optimal outcome. Endosonographic drainage of WON has lower rates of mortality and morbidity compared to surgical intervention. Several options regarding stent placement exist including the use of fully covered self-expandable metal stents and lumen-apposing metal stents. Depending upon their properties, each type of stent carries its own risk including the risk of migration. The endoscopist performing drainage of these fluid collections must take into account the number and size of these collections as well as the presence and amount of necrotic debris in order to choose the most appropriate technique and equipment in order to achieve optimal outcomes.</p></div>","PeriodicalId":43887,"journal":{"name":"Techniques in Gastrointestinal Endoscopy","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.tgie.2017.11.002","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Techniques in Gastrointestinal Endoscopy","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1096288317300888","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Endosonographic drainage of pseudocysts and walled-off necrosis (WON) has not been standardized. Drainage of pseudocysts via endosonographic guidance has high rates of technical success via the transmural approach. Alternative modalities including transpapillary endoscopic retrograde pancreatography with pancreatic duct sphincterotomy and pancreatic duct stent placement are options for patients with small pseudocysts and in the presence of pancreatic duct disruption. Drainage of WON has a variety of approaches and may require a combination of endoscopic or percutaneous techniques to achieve the optimal outcome. Endosonographic drainage of WON has lower rates of mortality and morbidity compared to surgical intervention. Several options regarding stent placement exist including the use of fully covered self-expandable metal stents and lumen-apposing metal stents. Depending upon their properties, each type of stent carries its own risk including the risk of migration. The endoscopist performing drainage of these fluid collections must take into account the number and size of these collections as well as the presence and amount of necrotic debris in order to choose the most appropriate technique and equipment in order to achieve optimal outcomes.
期刊介绍:
The purpose of each issue of Techniques in Gastrointestinal Endoscopy is to provide a comprehensive, current overview of a clinical condition or surgical procedure in gastrointestinal endoscopy, combining the effectiveness of an atlas with the timeliness of a journal. Each issue places a vigorous emphasis on diagnosis, rationale for and against a procedure, actual technique, management, and prevention of complications. The journal features abundant illustrations, line drawings and color artwork to guide readers through even the most complicated procedure.