Role of Endoscopy in the Diagnosis and Treatment of Inflammatory Pancreatic Fluid Collections
Publication Date: March 2, 2016
Summary
We recommend that endoscopic drainage of PFCs be performed only after sufficient exclusion of alternative diagnoses, such as cystic pancreatic neoplasms and pseudoaneurysms. (⊕⊕⊕⊕)
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We recommend waiting for maturation of the cyst wall of PFCs before endoscopic intervention. (⊕⊕⊕o)
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We recommend drainage of symptomatic pancreatic pseudocysts. (⊕⊕⊕o)
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We suggest drainage of rapidly enlarging pancreatic pseudocysts. (⊕⊕oo)
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We recommend drainage of all infected PFCs in patients who fail to improve with conservative management alone. (⊕⊕⊕⊕)
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We recommend drainage of symptomatic sterile necrosis lasting more than 8 weeks after the onset of acute pancreatitis. (⊕⊕⊕o)
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We suggest that routine FNA of PFCs is not required to diagnose infected necrosis. (⊕⊕oo)
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We recommend that endoscopic drainage be considered for initial therapy before surgical drainage of pancreatic pseudocysts. (⊕⊕⊕o)
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We recommend using EUS for transmural drainage of PFCs in the absence of a luminal bulge or when portal hypertension is suspected. (⊕⊕⊕⊕)
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We recommend initial endoscopic transmural and/or percutaneous drainage of WON before consideration of endoscopic transmural necrosectomy or surgical drainage. (⊕⊕⊕o)
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We recommend that endoscopic drainage of PFCs be performed only with the availability of surgical and interventional radiology support. (⊕⊕⊕⊕)
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We suggest using CO2 when performing transmural drainage procedures. (⊕⊕oo)
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Title
Role of Endoscopy in the Diagnosis and Treatment of Inflammatory Pancreatic Fluid Collections
Authoring Organization
American Society for Gastrointestinal Endoscopy
Publication Month/Year
March 2, 2016
External Publication Status
Published
Country of Publication
US
Document Objectives
This guideline supplements and replaces our previous document on the role of endoscopy in the diagnosis and management of cystic lesions and inflammatory fluid collections of the pancreas
Inclusion Criteria
Female, Male, Adult, Older adult
Health Care Settings
Ambulatory, Emergency care, Hospital, Outpatient
Intended Users
Medical assistant, laboratory technician, nurse, nurse practitioner, physician, physician assistant
Scope
Assessment and screening, Diagnosis, Management
Diseases/Conditions (MeSH)
D010181 - Pancreatic Cyst, D010182 - Pancreatic Diseases
Keywords
inflammation, endoscopy, pancreatic fluid collections
Source Citation
Muthusamy, V. R., Chandrasekhara, V., Acosta, R. D., Bruining, D. H., Chathadi, K. V., Eloubeidi, M. A., … DeWitt, J. M. (2016). The role of endoscopy in the diagnosis and treatment of inflammatory pancreatic fluid collections. Gastrointestinal Endoscopy, 83(3), 481–488. doi:10.1016/j.gie.2015.11.027
Methodology
Number of Source Documents
135
Literature Search Start Date
January 2, 1990
Literature Search End Date
February 2, 2015