Endoscopic ultrasonography-guided endoscopic treatment of pancreatic pseudocysts and walled-off necrosis: New technical developments

Table 1 Modified according to the updated Atlanta classification for definition of peripancreatic fluid collections based on contrast enhanced computed tomography criteria[1]

	Acute phase < 4 wk	Late phase > 4 wk
Interstitial oedematous pancreatitis	Acute peripancreatic fluid collection (homogenous with fluid density, no definable wall, no necrosis, adjacent to pancreas, not intra-pancreatic)	Pancreatic pseudocyst (well circumscribed, usually round or oval, homogenous fluid density, no debris, well defined wall)
Necrotising pancreatitis	Acute necrosis (heterogenous and also non-liquid density, no definable wall, intra- and/or extrapancreatic location)	Walled-off necrosis (heterogenous and also non-liquid density, well defined wall, completely encapsulating, intra- and/or extrapancreatic location)

Table 2 Equipment for endoscopic ultrasonography-guided pseudocyst drainage

Ultrasound processor

Linear array echoscope with 3.8 mm instrument channel

19 G EUS needle or cytostome and HF generator

Stiff guidewires (e.g., JagwireTM)

Dilatation balloon catheter

Pigtail prosthesis (e.g., 10 F)

Fluoroscopy optional

Table 3 Covered self-expandable metal stents for endoscopic ultrasonography guided pancreatic cyst drainage

Stent	Company	Length (mm)	Internal diameter (mm)	Maximal flange diameter (mm)	Delivery device length (mm)	Delivery device diameter (Fr)
AxiosTM	Xlumena	10	10 or 15	21 or 24	1460	10.8
AixTM	Leufen	30	10 or 15	25	2300	10
NagiTM	Taewoong	10 or 20 or 30	10 or 12 or 14 or 16	22 or 24 or 26 or 28	1800	10.5
BCFTM Hanaro	M.I. Tech	30 or 40	10 or 12	25	1800	10.2