EUS-Guided Transmural Drainage of Pancreatic Fluid Collections: Keeping It Close

Pancreatic fluid collections (PFCs) can develop as a consequence of acute necrotizing pancreatitis, pancreatic duct (PD) disruption due to acute or chronic pancreatitis, pancreatic surgery, and trauma [1-3]. Based on the Revised Atlanta classification, PFCs are classified as acute peripancreatic fluid collections (APFC), pseudocysts, acute necrotic collection (ANC), and walled-off necrosis according to their morphology on imaging [1]. While most of these collections tend to resolve spontaneously, treatment is warranted for symptomatic PFCs. Symptoms, including abdominal pain, early satiety, jaundice, or weight loss, are often secondary to luminal (gastroduodenal) and/or biliary obstruction. Other indications for intervention include infection, bleeding and fistulization [4,5].