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World J Gastroenterol. Nov 14, 2013; 19(42): 7308-7315
Published online Nov 14, 2013. doi: 10.3748/wjg.v19.i42.7308
Published online Nov 14, 2013. doi: 10.3748/wjg.v19.i42.7308
Endoscopic management of complications of chronic pancreatitis
Jean-Marc Dumonceau, Division of Gastroenterology and Hepatology, Geneva University Hospital, 1211 Geneva, Switzerland
Carlos Macias-Gomez, Gastrointestinal Endoscopy Unit, Gastroenterology Service, Italian Hospital, 1181 Buenos Aires, Argentina
Author contributions: Dumonceau JM contributed to conception, design, data research and analysis and wrote the manuscript; Macias-Gomez C revised the manuscript for important intellectual content; both authors approved the current version for publication.
Correspondence to: Jean-Marc Dumonceau, MD, PhD, Division of Gastroenterology and Hepatology, Geneva University Hospital, Rue Gabrielle Perret Gentil 4, 1211 Geneva, Switzerland. jmdumonceau@hotmail.com
Telephone: +41-22-3729340 Fax: +41-22-3729366
Received: June 10, 2013
Revised: July 15, 2013
Accepted: July 17, 2013
Published online: November 14, 2013
Revised: July 15, 2013
Accepted: July 17, 2013
Published online: November 14, 2013
Core Tip
Core tip: Endoscopy is the first-choice treatment of pancreatic pseudocysts. The transduodenal route may be preferable over the transgastric route. Two transmural double pigtail stents should be left for at least 2 mo. In the case of a disconnected pancreatic tail, secretin-enhanced magnetic resonance pancreatography should be obtained to decide about stent removal. Biliary strictures should be thoroughly investigated to rule out malignancy. To this aim, improved methods of biliary sampling have become available. Even with multiple biliary stents, potentially fatal cholangitis is frequent in the absence of regular stent revision. Fully covered self-expandable metal stents have provided 50% mid-term success.