Advancements in the endoscopic treatment of pancreatic fluid collections

Li, Jing; Yu, Yang; Zhang, Shutian

doi:10.1016/j.cdtm.2020.03.001

Cited by 5 publications

(3 citation statements)

References 74 publications

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“…Given most patients with PPC are prone to choose plastic stents for drainage with less cost and good efficacy, 29 there is a small sample of patients with PPC undergoing LAMS drainage (n = 2) in our series. As for better treatment effect, some patients with the good economic conditions may choose LAMS with a larger diameter to drain cyst effectively.…”

Section: Discussionmentioning

confidence: 99%

Comparative outcomes of endoscopic ultrasound‐guided lumen‐apposing mental stents drainage for pancreatic pseudocysts and walled‐off necrosis: Case series and meta‐analysis

Zhang

Zhou

et al. 2021

Chronic Diseases and Translational Medicine

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Background Endoscopic ultrasound (EUS)-guided transmural drainage for pancreatic fluid collections (PFCs) has become the first-line treatment with quicker recovery and more minor injury compared with surgery and percutaneous drainage. The efficacy of stents implantation and drainage for different PFCs remains controversial, especially lumen-apposing metal stents (LAMS). This study aimed to compare the efficacy and safety of LAMS drainage for pancreatic pseudocysts (PPC) and walled-off necrosis (WON). Methods A meta-analysis was performed for LAMS drainage for WON and PPC by systematically searching PubMed, Cochrane, and Embase databases from January 2010 to January 2020. From 2017 to 2019, 12 patients who were treated with LAMS drainage for PFCs in our medical center were also reviewed and included in this study. Results Combining 11 copies of documents with the data from our medical center, a total of 585 patients with PFCs were enrolled in this meta-analysis, including 343 patients with WON and 242 with PPC. The technical success rate in WON is not significantly different from that of PPC ( P = 0.08 > 0.05). The clinical success of LAMS placement was achieved in 99% vs 89% in PPC and WON, respectively (RR = 0.92, 95% CI: 0.86–0.98, P = 0.01 < 0.05). The further intervention of direct endoscopic necrosectomy was required by 60% of patients in WON group. There was no significant difference in the incidence of adverse events, including infection, bleeding, stent migration and stent occlusion, after LAMS placement between WON and PPC. Conclusions Endoscopic ultrasound-guided LAMS for PFCs are feasible, effective with preferable technical and clinical success rates. The clinical effect of LAMS on PPC is slightly better than that of WON, but its adverse reactions still need to be verified in a large-sample prospective study.

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Section: Discussionmentioning

confidence: 99%

Comparative outcomes of endoscopic ultrasound‐guided lumen‐apposing mental stents drainage for pancreatic pseudocysts and walled‐off necrosis: Case series and meta‐analysis

Zhang

Zhou

et al. 2021

Chronic Diseases and Translational Medicine

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“…EUS-guided transmural drainage is the first-line option for the treatment of pancreatic pseudocysts when drainage is indicated[ 76 , 81 ]. The advantage of EUS is that it does not require the pseudocyst to produce an obvious bulge into the lumen of the stomach or duodenum to be amenable for drainage and allows for a safer needle puncture under ultrasonic guidance.…”

Section: Managementmentioning

confidence: 99%

Pancreatic pseudocyst: The past, the present, and the future

Koo,

Liau,

Kryvoruchko

et al. 2024

World J Gastrointest Surg

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A pancreatic pseudocyst is defined as an encapsulated fluid collection with a well-defined inflammatory wall with minimal or no necrosis. The diagnosis cannot be made prior to 4 wk after the onset of pancreatitis. The clinical presentation is often nonspecific, with abdominal pain being the most common symptom. If a diagnosis is suspected, contrast-enhanced computed tomography and/or magnetic resonance imaging are performed to confirm the diagnosis and assess the characteristics of the pseudocyst. Endoscopic ultrasound with cyst fluid analysis can be performed in cases of diagnostic uncertainty. Pseudocyst of the pancreas can lead to complications such as hemorrhage, infection, and rupture. The management of pancreatic pseudocysts depends on the presence of symptoms and the development of complications, such as biliary or gastric outlet obstruction. Management options include endoscopic or surgical drainage. The aim of this review was to summarize the current literature on pancreatic pseudocysts and discuss the evolution of the definitions, diagnosis, and management of this condition.

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“…Techniques to drain PFCs have evolved from percutaneous and invasive surgical necrosectomy to direct endoscopic necrosectomy as endoscopic technology has advanced. The novel endoscopic approach has drastically improved patient morbidity and mortality [ 2 ]. This review explores the role of endoscopy in the management of PFCs.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Management of Pancreatic Fluid Collections

Dorrell

Pawa

2021

JCM

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Pancreatic fluid collections (PFCs) are a common sequela of pancreatitis. Most PFCs can be managed conservatively, but symptomatic PFCs require either surgical, percutaneous, or endoscopic intervention. Recent advances in the therapeutics of PFCs, including the step-up approach, endoscopic ultrasound-guided transmural drainage with lumen apposing metal stents, and direct endoscopic necrosectomy, have ushered endoscopy to the forefront of PFCs management and have allowed for improved patient outcomes and decreased morbidity. In this review, we explore the progress and future of endoscopic management of PFCs.

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Advancements in the endoscopic treatment of pancreatic fluid collections

Cited by 5 publications

References 74 publications

Comparative outcomes of endoscopic ultrasound‐guided lumen‐apposing mental stents drainage for pancreatic pseudocysts and walled‐off necrosis: Case series and meta‐analysis

Comparative outcomes of endoscopic ultrasound‐guided lumen‐apposing mental stents drainage for pancreatic pseudocysts and walled‐off necrosis: Case series and meta‐analysis

Pancreatic pseudocyst: The past, the present, and the future

Endoscopic Management of Pancreatic Fluid Collections

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