EUS 2008 Working Group document: evaluation of EUS-guided drainage of pancreatic-fluid collections (with video)

摘要

In recent years, EUS-guided transmural drainage of symptomatic pancreatic-fluid collections has increasingly been performed. Before the introduction of linear EUS in the 1990s and the subsequent development of EUS-guided drainage procedures, the options available included surgical drainage, percutaneous drainage by using radiologic guidance, and non-EUS-guided endoscopic transmural drainage. This section of the EUS 2008 Working Group Proceeding evaluates the current status of EUS in the management of pancreatic-fluid collections and provides recommendations for future research and technology development.CURRENT APPROACHES AND LIMITATIONSThe current approaches and limitations are shown in Table 1.Surgical drainageTraditionally, open surgery has been considered the standard treatment for drainage of symptomatic pancreatic-fluid collections. However, surgery requires general anesthesia and is more invasive when compared with percutaneous and endoscopic options. The clinical outcome, as well as the morbidity and mortality rates, also differs depending on the nature of the fluid collections.Pseudocysts. Surgical drainage of pancreatic pseudo-cysts involves creating a cystogastrostomy or cystojejunos-tomy. Although surgical drainage has high success rates, morbidity rates of 10% to 30% and mortality rates of 1% to 5% were reported.