Endoscopic Ultrasound Guided Drainage of Pancreatic Fluid Collections in Acute Pancreatitis: Literature Review


Mantas Markauskas1, Raimundas Darafėjus1

1Faculty of Medicine, Vilnius University, Vilnius, Lithuania


Acute pancreatitis is an inflammatory condition of the pancreas most commonly caused by bile duct stones or excessive use of alcohol. During acute pancreatitis, aggressive pancreatic enzymes begin to break down the pancreas, enter into the bloodstream and trigger the whole system response. The main symptom of the disease is acute pain in the epigastrium, which spreads to the back. Diagnosis of acute pancreatitis is based on anamnesis, physical examination, laboratory tests, medical imaging and Atlanta classification, which was concluded in 2012. Acute pancreatitis has two phases – early and late, and two types – interstitial edematous and necrotizing. Complications of the disease can be local, systemic, peripancreatic and can cause organ failure. One of the most common complications of acute pancreatitis is pancreatic fluid collections, which are characterized using the 2012 Atlanta classification. This complication can be diagnosed using transabdominal ultrasound, contrast-enhanced computed tomography, magnetic resonance imaging, positron emission tomography scan, endoscopic retrograde cholangiopancreatography and endoscopic ultrasound. Once a pancreatic fluid collections diagnosis has been made and conservative treatment has failed, interventional therapies such as percutaneous, surgical or endoscopic transpapillary drainage must be used. However, these treatments do not always produce the desired result and are associated with a variety of complications, so the discussions about the benefits of endoscopic ultrasound guided drainage in the treatment of pancreatic fluid collections are increasing. The results of the current studies show, that endoscopic ultrasound guided drainage of pancreatic fluid collections is a safe and efficient choice for the treatment of symptomatic pancreatic fluid collections.

Keywords: acute pancreatitis, endoscopic ultrasound guided drainage, pancreatic fluid collections.