Endoscopic Ultrasound-Guided Transluminal Drainage for Peripancreatic Fluid Collections: Where Are We Now?
Open Access
- 1 July 2014
- journal article
- review article
- Published by The Editorial Office of Gut and Liver in Gut and Liver
- Vol. 8 (4), 341-355
- https://doi.org/10.5009/gnl.2014.8.4.341
Abstract
Endoscopic drainage for pancreatic and peripancreatic fluid collections (PFCs) has been increasingly used as a minimally invasive alternative to surgical or percutaneous drainage. Recently, endoscopic ultrasound-guided transluminal drainage (EUS-TD) has become the standard of care and a safe procedure for nonsurgical PFC treatment. EUS-TD ensures a safe puncture, avoiding intervening blood vessels. Single or multiple plastic stents (combined with a nasocystic catheter) were used for the treatment of PFCs for EUS-TD. More recently, the use of covered self-expandable metallic stents (CSEMSs) has provided a safer and more efficient approach route for internal drainage. We focused our review on the best approach and stent to use in endoscopic drainage for PFCs. We reviewed studies of EUS-TD for PFCs based on the original Atlanta Classification, including case reports, case series, and previous review articles. Data on clinical outcomes and adverse events were collected retrospectively. A total of 93 patients underwent EUS-TD of pancreatic pseudocysts using CSEMSs. The treatment success and adverse event rates were 94.6% and 21.1%, respectively. The majority of complications were of mild severity and resolved with conservative therapy. A total of 56 patients underwent EUS-TD using CSEMSs for pancreatic abscesses or infected walled-off necroses. The treatment success and adverse event rates were 87.8% and 9.5%, respectively. EUS-TD can be performed safely and efficiently for PFC treatment. Larger diameter CSEMSs without additional fistula tract dilation for the passage of a standard scope are needed to access and drain for PFCs with solid debris.Keywords
This publication has 46 references indexed in Scilit:
- Equal Efficacy of Endoscopic and Surgical Cystogastrostomy for Pancreatic Pseudocyst Drainage in a Randomized TrialGastroenterology, 2013
- Pancreatic Fluid Collection Drainage by Endoscopic Ultrasound: An UpdateClinical Endoscopy, 2013
- Use of a novel covered self-expandable metal stent with an anti-migration system for endoscopic ultrasound-guided drainage of a pseudocystWorld Journal of Gastrointestinal Endoscopy, 2013
- Endosonography-guided drainage of pancreatic fluid collections with a novel lumen-apposing stentSurgical Endoscopy, 2012
- Single-step endoscopic ultrasonography-guided drainage of peripancreatic fluid collections with a single self-expandable metal stent and standard linear echoendoscopeEndoscopy, 2012
- Covered self expandable metallic stent with flared plastic one inside for pancreatic pseudocyst avoiding stent dislodgementWorld Journal of Gastrointestinal Endoscopy, 2012
- Endoscopic ultrasound-guided drainage of pancreatic fluid collectionsWorld Journal of Gastrointestinal Endoscopy, 2012
- Endoscopic ultrasound-guided transmural drainage for pancreatic fistula or pancreatic duct dilation after pancreatic surgerySurgical Endoscopy, 2011
- Transenteric drainage of pancreatic-fluid collections with fully covered self-expanding metallic stents (with video)Gastrointestinal Endoscopy, 2008
- Endoscopic transmural drainage of pancreatic pseudocysts: results of a national and an international survey of ASGE membersGastrointestinal Endoscopy, 2006