GRUPUGE Perspective: Endoscopic Ultrasound-Guided Drainage of Peripancreatic Collections

Abstract

Pancreatic and peripancreatic collections (PPC) are a known complication of acute pancreatitis. They are categorized into four types of collection: (1) acute peripancreatic fluid collection, (2) pseudocyst, (3) acute necrotic collection and (4) walled-off necrosis. Most PPC resolve spontaneously or are persistent but asymptomatic. Intervention is needed in a minority of patients with infected or symptomatic collection. Endoscopic ultrasound-guided transmural drainage is currently the first-line treatment option for PPC management. It has shown great technical and clinical success, similar to percutaneous or surgical approaches, but with lower morbidity and costs and better quality of life. In this review article, the GRUPUGE presents an updated perspective on the potential role of endoscopic ultrasound-guided drainage of peripancreatic collections, addressing the selection criteria and the technical issues of different techniques and analysing emerging data on their efficacy and safety.

Technical and Clinical Outcomes of Using a Single Wide-Caliber Double-Pigtail Stent for Endoscopic Ultrasound-Guided Pancreatic Pseudocyst Drainage: A Multicenter Prospective Study

“…All included patients received periprocedural antibiotic course of 3rd generation cephalosporins or quinolones for a median period of 5 days. While broad-spectrum antibiotics are strongly recommended for patients with an infected pseudocyst either empirically or based on culture sensitivity [ 21 ], its prophylactic role for noninfected pseudocyst has not been studied [ 7 ].…”

“…According to duration and amount of necrosis, PPC is categorized into four types: acute peripancreatic fluid collection, pseudocyst, acute necrotic collection, and walled-off necrosis (WON) [ 7 ]. The unresolved PPC may be asymptomatic or present with epigastric pain, dyspepsia, fever, gastric outlet obstructive symptoms, or biliary obstruction [ 8 ].…”

“Orphaned” Stomach—An Infrequent Complication of Gastric Bypass Revision

“…Use of directed transgastric stents is increasingly common for other indications. Mature pancreatic pseudocysts can be internally drained through the posterior stomach with endoscopic and ultrasound guidance [20][21][22][23]. After RGB, gastro-gastric stents have been used to allow antegrade access to the duodenum and biliary system for diagnostic and therapeutic procedures [20,24,25].…”

Current treatment of pancreatic pseudocysts: a systematic review

“…Большинство современных исследователей, сравнивая ХД с мини-инвазивными методами лечения, такими как ЭД, пришли к выводу, что ХД и ЭД имеют одинаковые показатели клинического успеха. Однако лечение ЭД было сопряжено с низкими затратами и непродолжительным пребыванием в больнице, что делало ЭД более предпочтительным методом, чем ХД [40,41].…”

“…Процедура ЭД была впервые проведена в 1989 году и с тех пор превратилась в наиболее приемлемую альтернативу хирургическому вмешательству [44]. В настоящее время этот метод стал более предпочтительным в лечении псевдокист поджелудочной железы, поскольку он менее инвазивен, чем хирургический, и не требует наружного дренирования с высоким риском инфицирования дренажной трубки, а также имеет высокий показатель эффективности [40,45,46]. Целью ЭД при лечении псевдокист поджелудочной железы является установление связи между псевдокистой и желудочно-кишечным трактом, будь то желудок, двенадцатиперстная кишка или даже тощая кишка [36,[47][48][49].…”