ASGE Postgraduate Course at ACG: Evidence-based Updates for the Practicing Gastroenterologist (On-Demand) | October 2021 OLPGATACG21-Endoscopic Management of Pancreatic Fluid Collections

Video Transcription

Video Summary

The video discusses the management of pancreatic fluid collections. Pancreatic fluid collections are common, but the majority resolve on their own. However, large collections associated with severe pancreatitis may require drainage. It is important to exclude pancreatic cystic neoplasms from the management process to avoid complications. The old paradigm of drainage based on size or duration of the cyst is outdated. Instead, drainage is recommended if the cyst is causing symptoms, infection, or compression of critical structures. The treatment algorithm involves determining if the cyst is inflammatory and if drainage is indicated. Conservative management is preferred initially, and percutaneous drainage is considered if conservative management fails. Endoscopic or surgical drainage may be required for mature collections. Endoscopic drainage of pseudocysts has replaced surgical drainage as the dominant strategy. Endoscopic necrosectomy may be required for walled-off necrosis, and surgical options are considered for complex cases. Complications include infection, bleeding, perforation, and pancreatitis. There are ongoing discussions and controversies surrounding the best drainage strategy and adjunctive treatments.

Asset Subtitle

B. Joseph Elmunzer, MD

Keywords

pancreatic fluid collections

drainage

conservative management

endoscopic drainage

surgical drainage

complications