Year 2020 / Volume 112 / Number 6
Review
Management of pancreatic collections: an update

483-490

DOI: 10.17235/reed.2020.6814/2019

Ana García García de Paredes, Sergio López-Durán, José Ramón Foruny Olcina, Agustín Albillos, Enrique Vázquez-Sequeiros,

Abstract
Pancreatic fluid collections frequently occur in the context of moderate and severe acute pancreatitis, and may also appear as a complication of chronic pancreatitis, pancreatic surgery or trauma. It is essential to adhere to the Atlanta classification nomenclature that subclassifies them into four categories (acute peripancreatic fluid collections, acute necrotic collections, pseudocysts, and walled-off necrosis) since it has an impact on prognosis and management. Pseudocysts and walled-off pancreatic necrosis are encapsulated pancreatic fluid collections characterized by a surrounding inflammatory wall, which typically develops three to four weeks after the onset of acute pancreatitis. Most pancreatic fluid collections resolve spontaneously and do not require intervention. However, when they become symptomatic or complicated drainage is indicated, and endoscopic ultrasound-guided drainage has become first-line treatment of encapsulated collections. Drainage of pseudocysts is relatively straightforward due to their liquid content. However, in walled-off necrosis the presence of solid necrotic debris can make treatment more challenging and therefore multidisciplinary management in experienced centers is recommended, being a step-up approach the current standard of care. In this review, we aim to address the management of pancreatic fluid collections with an especial focus on endoscopic drainage.
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Comments

15/12/2020 0:27:09
Muy interesante actualización


09/06/2020 18:43:26
Buenas tardes desde Mèrida-Venezuela, les escribe el Dr Gerardo A. Casanova A, mèdico gastroenteròlogo, excelente artìculo, mis felcitaciones a los autoras/es.


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García García de Paredes A, López-Durán S, Foruny Olcina J, Albillos A, Vázquez-Sequeiros E. Management of pancreatic collections: an update. 6814/2019


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Publication history

Received: 12/12/2019

Accepted: 19/01/2020

Online First: 26/05/2020

Published: 08/06/2020

Article revision time: 23 days

Article Online First time: 166 days

Article editing time: 179 days


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