ASGE Postgraduate Course at ACG: Evidence-based Updates for the Practicing Gastroenterologist | October 2021-Endoscopic Management of Pancreatic Fluid Collections

Video Transcription

Video Summary

The video discussed the management of pancreatic fluid collections, focusing on acute collections associated with pancreatitis. The majority of pancreatic fluid collections are of no clinical consequence and resolve spontaneously. However, collections larger than 5-6 centimeters associated with severe and necrotizing pancreatitis may require drainage. It is important to exclude a neoplastic cyst before drainage to avoid complications. The old paradigm of drainage based on size and duration of the cyst is outdated, and drainage should be based on symptoms, infection, or compression of critical structures. The video also discussed the use of endoscopic and surgical drainage procedures for different types of collections. Endoscopic drainage is the preferred approach for pseudocysts, while walled-off necrosis may require direct endoscopic necrosectomy. The video highlighted the technical aspects and potential complications of these procedures. Current evidence supports the use of endoscopic drainage, which is associated with lower costs and shorter hospital stays compared to surgery. However, surgery may still be necessary for complex cases or patients who do not respond to endoscopic treatment. Additional considerations and ongoing research topics were also mentioned.

Asset Subtitle

B. Joseph Elmunzer, MD

Keywords

management

pancreatic fluid collections

acute collections

pancreatitis

drainage procedures

endoscopic drainage