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©The Author(s) 2020.
World J Gastroenterol. Dec 7, 2020; 26(45): 7104-7117
Published online Dec 7, 2020. doi: 10.3748/wjg.v26.i45.7104
Published online Dec 7, 2020. doi: 10.3748/wjg.v26.i45.7104
Ref. | Study object | Study objective | Descriptors | Classification | Practical implication |
Dhir et al[23], 2018 | EUS-drained WON | Pancreatography patters in WON and collection recurrence | -Duct disconnection; -Leaks | -Type I: Disconnection in the neck/body region, with a ductal leak at the proximal end; -Type II: Disconnected duct with a WON distal to the disconnection. It is not possible to ascertain the ductal communication of WON; -Type III: ductal leak without disconnection; -Type IV: Shows a noncommunicating WON, with no disconnection | Recurrence is higher in patters w/ disconnection (types I and II): -Type I: 5/35 patients (14.3%)–62.5% of recurrences; -Type II: 2/18 patients (11.1%) - 25% of recurrences; -Type III: 0/26 patients (0%) - 0% of recurrences; -Type IV: 1/8 patients (12.5%)–12.5% of recurrences |
Mutignani et al[35], 2017 | All pancreatic fistulas | Guide endoscopic approach | -Leakages; -Disruption (partial); -Disconnection (total) | -Type I: Leakages from small side brunches. IH: head | IB: body | IT: tail; -Type II: Leak in the MPD Open (IIO) or Close (IIC); -Type III: leaks after pancreatectomy; IIIP: Proximal pancreas (after distal pancreatectomy); IIID: Distal pancreas (after pancreaticoduodenectomy) | -IH and IB: Bridging OR NPD; -IT: Bridging OR cianoacrilate/fibrin/glue/polymer injection at pancreatic tail; -IIO: Bridging OR NPD OR transpapillary stent; -IIC: EUS transmural drain of collection from excluded gland OR EUS pancreaticogastrostomy OR Conversion to IIO and treat as IIO; -IIIP: Transpapillary stent; -IIID: Few endoscopic options. EUS transmural drainage OR nasojejunal drain at the level of dehiscence in continuous aspiration |
Nealon et al[37], 2009 | Pseudocyst due to pancreatitis1 | Guide the best approach: endoscopic, interventional radiology or surgical intervention | -Normal2; -Stricture; -Chronic pancreatitis; -Occlusion; -Communication / no communication with collection | -Type I for normal ducts, IA: No communication, IB: With communication; -type II for duct strictures; IIA: no communication; IIB: with communication; -Type III for duct occlusion or disconnected duct syndrome; IIIA: no communication; IIIB: with communication; - Type IV for changes of chronic pancreatitis; IVA: no communication, IVB: with communication | -Type I: Endoscopic or percutaneous management; unlikely to require operation; -Type II: Endoscopic management depending on the magnitude and length of the stricture - transpapillary stents for selected ducts; -Type III and type IV: Surgical intervention exclusively |
Nealon et al[41], 2002 | Pseudocyst1 that underwent pancreatography by ERCP | Guide the best approach between percutaneous drainage or surgical intervention | -Normal2; -Strictures; -Complete cutoff; -Chronic pancreatitis;-MPD-pseudocyst communication or not | -Type I: normal duct/no communication with cyst; -Type II: normal duct with duct–cyst communication; -Type III: otherwise normal duct with stricture and no duct–cyst communication; -Type IV: otherwise normal duct with stricture and duct–cyst communication; -Type V: otherwise normal duct with complete cut-off; -Type VI: chronic pancreatitis, no duct–cyst communication; -Type VII: chronic pancreatitis with duct–cyst communication | -Type I: consider percutaneous drainage (PD); -Type II: avoid PD; -Type III: consider PD treatment; -Type IV: surgery (avoid PD); -Type V: surgery (avoid PD); -Type VI: surgery (avoid PD); -Type VII: surgery (avoid PD) |
Nordback et al[7], 1988 | Pseudocyst1 that underwent pancreatography by ERCP | Guide the best approach | -Stenosis; -Pseudocyst opens to the duct; -Pseudocyst is filled | -Type I: MPD is imaged up to the end without much stenosis, Pseudocyst may (Type IA) or may not (IB) be filled, but is further away from the main pancreatic duct; -Type II: no main duct stenosis and pseudocyst opens to the duct; -Type III: stenosis of the main pancreatic duct, + filling of the pseudocyst behind the stenosis (IIIA), or not (IIIB) | Type I: PD is a good option; Type II: expectant management for 12 wk, if persistent: Internal drainage (PD, endoscopically, surgery); Type III: Internal drainage (external drainage contraindicated); caudal resection |
- Citation: Proença IM, dos Santos MEL, de Moura DTH, Ribeiro IB, Matuguma SE, Cheng S, McCarty TR, do Monte Junior ES, Sakai P, de Moura EGH. Role of pancreatography in the endoscopic management of encapsulated pancreatic collections – review and new proposed classification. World J Gastroenterol 2020; 26(45): 7104-7117
- URL: https://www.wjgnet.com/1007-9327/full/v26/i45/7104.htm
- DOI: https://dx.doi.org/10.3748/wjg.v26.i45.7104