Clin Endosc.
2024 Nov;57(6):735-746. 10.5946/ce.2023.254.
Drainage for fluid collections post pancreatic surgery and acute pancreatitis: similar but different?
- Nakai Y
1,2 - Matsubara S3
- Mukai T4
- Hamada T1,5
- Sasaki T5
- Ishiwatari H6
- Hijioka S7
- Shiomi H8
- Takenaka M9
- Iwashita T10
- Masuda A11
- Saito T1
- Isayama H12
- Yasuda I13
- for the WONDERFUL study group in Japan1
- Affiliations
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- 1Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- 2Department of Endoscopy and Endoscopic Surgery, The University of Tokyo Hospital, Tokyo, Japan
- 3Department of Gastroenterology and Hepatology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
- 4Department of Gastroenterological Endoscopy, Kanazawa Medical University, Ishikawa, Japan
- 5Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
- 6Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
- 7Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan
- 8Division of Hepatobiliary and Pancreatic Diseases, Department of Gastroenterology, Hyogo Medical University, Hyogo, Japan
- 9Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan
- 10First Department of Internal Medicine, Gifu University Hospital, Gifu, Japan
- 11Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan
- 12Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
- 13Third Department of Internal Medicine, University of Toyama, Toyama, Japan
- KMID: 2561155
- DOI: http://doi.org/10.5946/ce.2023.254
Abstract
- Postoperative pancreatic fistulas (POPFs) are common adverse events that occur after pancreatic surgery. Endoscopic ultrasonography (EUS)-guided drainage (EUS-D) is a first-line treatment, similar to that for pancreatic fluid collection (PFCs) after acute pancreatitis. However, some POPFs do not develop fluid collections depending on the presence or location of the surgical drain, whereas others develop fluid collections, such as postoperative fluid collections (POPFCs). Although POPFCs are similar to PFCs, the strategy and modality for POPF management need to be modified according to the presence of fluid collections, surgical drains, and surgical type. As discussed for PFCs, the indications, timing, and selection of interventions or stents for EUS-D have not been fully elucidated for POPFs. In this review, we discuss the management of POPFs and POPFCs in comparison with PFCs due to acute pancreatitis and summarize the topics that should be addressed in future studies.
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