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Endoscopic ultrasound drainage of pancreatic fluid collections: do we know enough about the best approach?
Pancreatic fluid collection often occurs as a local complication of acute pancreatitis, and drainage is indicated in symptomatic patients. The drainage may be surgical, percutaneous, or endoscopic ultrasound (EUS) guided. In symptomatic collections older than 4 weeks and localized in the upper abdom...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10357067/ https://www.ncbi.nlm.nih.gov/pubmed/37485492 http://dx.doi.org/10.1177/17562848231180047 |
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author | Seicean, Andrada Pojoga, Cristina Rednic, Voicu Hagiu, Claudia Seicean, Radu |
author_facet | Seicean, Andrada Pojoga, Cristina Rednic, Voicu Hagiu, Claudia Seicean, Radu |
author_sort | Seicean, Andrada |
collection | PubMed |
description | Pancreatic fluid collection often occurs as a local complication of acute pancreatitis, and drainage is indicated in symptomatic patients. The drainage may be surgical, percutaneous, or endoscopic ultrasound (EUS) guided. In symptomatic collections older than 4 weeks and localized in the upper abdomen, EUS-guided drainage is the first choice of treatment. Lumen-apposing metal stents are useful in cases of walled-off necrosis, facilitating access to the cavity; however, they do not reduce the number of necrosectomy sessions required. In most pancreatic pseudocysts requiring drainage, plastic stents remain the first choice of treatment. This review aimed to summarize the principles and techniques of step-up therapy of pancreatic fluid collections, including preprocedural and postprocedural assessment and practical approaches of drainage and necrosectomy, making available evidence more accessible to endoscopists aiming to train for this procedure. Successful and safe EUS drainage connotes early recognition and treatment of complications and the presence of a multidisciplinary team for optimal patient management. However, the best time for necrosectomy, modality of drainage method (lumen-apposing metal stents or plastic stents), and duration of antibiotherapy are still under evaluation. |
format | Online Article Text |
id | pubmed-10357067 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-103570672023-07-21 Endoscopic ultrasound drainage of pancreatic fluid collections: do we know enough about the best approach? Seicean, Andrada Pojoga, Cristina Rednic, Voicu Hagiu, Claudia Seicean, Radu Therap Adv Gastroenterol Review Pancreatic fluid collection often occurs as a local complication of acute pancreatitis, and drainage is indicated in symptomatic patients. The drainage may be surgical, percutaneous, or endoscopic ultrasound (EUS) guided. In symptomatic collections older than 4 weeks and localized in the upper abdomen, EUS-guided drainage is the first choice of treatment. Lumen-apposing metal stents are useful in cases of walled-off necrosis, facilitating access to the cavity; however, they do not reduce the number of necrosectomy sessions required. In most pancreatic pseudocysts requiring drainage, plastic stents remain the first choice of treatment. This review aimed to summarize the principles and techniques of step-up therapy of pancreatic fluid collections, including preprocedural and postprocedural assessment and practical approaches of drainage and necrosectomy, making available evidence more accessible to endoscopists aiming to train for this procedure. Successful and safe EUS drainage connotes early recognition and treatment of complications and the presence of a multidisciplinary team for optimal patient management. However, the best time for necrosectomy, modality of drainage method (lumen-apposing metal stents or plastic stents), and duration of antibiotherapy are still under evaluation. SAGE Publications 2023-07-16 /pmc/articles/PMC10357067/ /pubmed/37485492 http://dx.doi.org/10.1177/17562848231180047 Text en © The Author(s), 2023 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Review Seicean, Andrada Pojoga, Cristina Rednic, Voicu Hagiu, Claudia Seicean, Radu Endoscopic ultrasound drainage of pancreatic fluid collections: do we know enough about the best approach? |
title | Endoscopic ultrasound drainage of pancreatic fluid collections: do we know enough about the best approach? |
title_full | Endoscopic ultrasound drainage of pancreatic fluid collections: do we know enough about the best approach? |
title_fullStr | Endoscopic ultrasound drainage of pancreatic fluid collections: do we know enough about the best approach? |
title_full_unstemmed | Endoscopic ultrasound drainage of pancreatic fluid collections: do we know enough about the best approach? |
title_short | Endoscopic ultrasound drainage of pancreatic fluid collections: do we know enough about the best approach? |
title_sort | endoscopic ultrasound drainage of pancreatic fluid collections: do we know enough about the best approach? |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10357067/ https://www.ncbi.nlm.nih.gov/pubmed/37485492 http://dx.doi.org/10.1177/17562848231180047 |
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