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Endoscopic Drainage of Pancreatic Fluid Collections

  • Natalie Danielle Cosgrove
  • Pushpak Taunk
  • Haroon Shahid
  • Ali Ahmed SiddiquiEmail author
Chapter

Abstract

Pancreatic fluid collections are fluid-filled cavities that develop and evolve in the setting of acute and chronic pancreatitis as well as pancreatic necrosis. While most fluid collections resolve spontaneously, many will mature over several weeks into organized collections with a radiologically visualized non-epithelial lined capsule. These collections are referred to as pancreatic pseudocysts or walled-off necrosis, depending on their internal components. Pseudocysts contain primarily liquid contents while walled-off necrosis contains variable amounts of both solid and liquid debris. Symptomatic and infected collections are indications for intervention. The primary management was previously surgical, but has become less invasive over the past several decades with endoscopic drainage and debridement, now the favored approach in most centers. This chapter discusses how and when endoscopic drainage should be performed and the role of ERCP and EUS in performing these procedures.

Keywords

Pancreatic fluid collections Acute peripancreatic fluid collections Acute necrotic collections Pseudocysts Walled-off necrosis Transmural drainage Transpapillary drainage Pancreatic ductal disruption Disconnected pancreatic duct Cystenterostomy Cystogastrostomy Cystduodenostomy Endoscopic transmural necrosectomy Necrosectomy Multiple transluminal gateway technique Single transluminal gateway technique Single transluminal gateway transcystic multiple drainage technique Videoscopic assisted retroperitoneal debridement Sinus tract endoscopy Percutaneous catheter drainage 

Supplementary material

Video 14.1

The accompanying video demonstrates Dr. Adler performing an endoscopic transluminal necrosectomy using a lumen-apposing stent (WMV 59561 kb).

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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Natalie Danielle Cosgrove
    • 1
  • Pushpak Taunk
    • 2
  • Haroon Shahid
    • 3
  • Ali Ahmed Siddiqui
    • 4
    Email author
  1. 1.Thomas Jefferson UniversityPhiladelphiaUSA
  2. 2.University of South FloridaTampaUSA
  3. 3.Thomas Jefferson University HospitalPhiladelphiaUSA
  4. 4.Department of GastroenterologyThomas Jefferson University HospitalPhiladelphiaUSA

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